Kajbafzadeh Abdol-Mohammad, Sharifi-Rad Lida, Seyedian Seyedeh Sanam Ladi, Mozafarpour Sarah, Paydary Koosha
Eur J Pediatr. 2014 Feb;173(2):197-201. doi: 10.1007/s00431-013-2120-6.
Voiding dysfunction is a common entity in pediatric urology. It is believed to have a multifactorial etiology. The aim of this study was to investigate whether there is an increased prevalence of generalized joint hypermobility (GJH) in children with voiding dysfunction compared to normal children. Moreover, the prevalence of voiding complaints in patients with and without GJH was assessed. A total of 226 children--aged 5 to 14 years--including 113 patients diagnosed with voiding dysfunction and 113 sex/age/body mass index-matched normal children were recruited. GJH was evaluated in both groups using the Beighton score (4 or more= hypermobile). In the patient’s group, GJH was significantly more frequent than in controls: 51/113 (45 %) versus 19/113 (17 %) (P=0.001). In addition, in both groups, GJH was more prominent in girls than boys (P<0.05). Urinary tract infection was the most frequent features in children with voiding dysfunction (64 %). In the subgroup of positive GJH, urinary tract infection remained the most common manifestation among the girls (P=0.003), while constipation was the most prevalent manifestation among the boys (P=0.001).
Our findings suggest that children with voiding dysfunction have significantly higher prevalence of GJH compared to normal children. Further studies are needed to determine the cause and effect of these two common presentations and will help to develop a multidisciplinary approach in understanding and management of voiding dysfunction in children.
排尿功能障碍是小儿泌尿外科的常见病症。其病因被认为是多因素的。本研究的目的是调查与正常儿童相比,排尿功能障碍儿童中全身关节过度活动(GJH)的患病率是否增加。此外,还评估了有和没有GJH的患者中排尿症状的患病率。共招募了226名5至14岁的儿童,其中包括113名被诊断为排尿功能障碍的患者和113名性别/年龄/体重指数匹配的正常儿童。两组均使用Beighton评分(4分或更高为关节活动过度)评估GJH。在患者组中,GJH的发生率明显高于对照组:51/113(45%)对19/113(17%)(P=0.001)。此外,在两组中,女孩的GJH比男孩更明显(P<0.05)。尿路感染是排尿功能障碍儿童最常见的特征(64%)。在GJH阳性亚组中,尿路感染仍是女孩中最常见的表现(P=0.003),而便秘是男孩中最普遍的表现(P=0.001)。
我们的研究结果表明,与正常儿童相比,排尿功能障碍儿童的GJH患病率明显更高。需要进一步研究来确定这两种常见表现之间的因果关系,并将有助于制定多学科方法来理解和管理儿童排尿功能障碍。