Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Centre Nis, Bul. Zorana Djindjica 48, 18 000 Nis, Serbia.
Institute for Rehabilitation, Sokobanjska 17, 11000 Belgrade, Serbia.
J Pediatr Urol. 2014 Dec;10(6):1111-6. doi: 10.1016/j.jpurol.2014.03.021. Epub 2014 May 21.
To evaluate the types of constipation according to colonic transit time in chronically constipated children with dysfunctional voiding (bowel bladder dysfunction, BBD group) and to compare the results with transit type in children with chronic functional constipation without urinary symptoms (constipation group) and children with normal bowel habits, but with lower urinary tract symptoms (control group).
One-hundred and one children were included and their medical histories were obtained. The BBD group kept a voiding diary, and underwent urinalyses and urine culture, ultrasound examination of bladder and kidneys and uroflowmetry with pelvic floor electromyography. Radionuclear transit scintigraphy was performed in all children according to a standardized protocol. Patients were categorized as having either slow-transit (ST), functional fecal retention (FFR) or normal transit.
FFR was diagnosed in 31 out of 38 children with BBD, and 34 out of 43 children in the constipation group. ST was found in seven children with BBD, compared with nine children in the constipation group. The control group children demonstrated normal colonic transit. Urgency, daily urinary incontinence and nocturnal enuresis were noted only in children with FFR. Both children with ST constipation and FFR complained of difficulties during voiding, voiding postponement and urinary tract infections.
FFR is the most common form of constipation in children with dysfunctional voiding. However, some children might suffer from ST constipation. Differentiation between these two types of constipation is clinically significant because they require different treatment. Future studies with larger numbers of patients are needed to confirm the noted differences in urological symptoms in these two groups of constipated children..
评估伴有排尿功能障碍（肠膀胱功能障碍，BBD 组）的慢性便秘儿童的结肠通过时间的便秘类型，并将结果与无尿路症状的慢性功能性便秘儿童（便秘组）和有正常排便习惯但伴有下尿路症状的儿童（对照组）的通过类型进行比较。
纳入 101 例儿童，获取其病史。BBD 组记录排尿日记，并进行尿分析和尿液培养、膀胱和肾脏超声检查以及盆底肌电图下尿流率检查。所有儿童均按照标准化方案进行放射性核素通过闪烁显像。根据患者情况将其分为慢传输型（ST）、功能性粪便潴留（FFR）或正常传输型。
38 例 BBD 患儿中有 31 例诊断为 FFR，43 例便秘组患儿中有 34 例诊断为 FFR。BBD 组有 7 例患儿为 ST，便秘组有 9 例患儿为 ST。对照组患儿结肠通过正常。仅在 FFR 患儿中观察到尿急、每日尿失禁和夜间遗尿。ST 便秘和 FFR 患儿均诉排便困难、排尿延迟和尿路感染。
FFR 是伴有排尿功能障碍的儿童中最常见的便秘类型。然而，一些儿童可能患有 ST 便秘。这两种类型的便秘需要不同的治疗，因此对其进行区分在临床上具有重要意义。需要进一步进行更多患者数量的研究来证实这两组便秘儿童的尿症状差异。
