Van Batavia Jason P, Combs Andrew J
Division of Urology, Children's Hospital of Philadelphia, 3rd Floor, Wood Building, 34th and Civic Center Blvd, Philadelphia, PA, 19104, USA.
Department of Urology, New York Presbyterian-Weill Cornell Medical Center, New York, NY, USA.
Curr Urol Rep. 2018 Apr 6;19(5):34. doi: 10.1007/s11934-018-0784-1.
The symptoms of lower urinary tract dysfunction (LUTD) including urinary incontinence, frequency, and urgency are among the most common reasons children are referred to pediatric urologists. Despite this, the workup for LUTD is often time consuming and a source of frustration for patients, parents, and clinicians alike. In the current review, we summarize the important role non-invasive testing plays in the diagnosis and management of children with LUTD and to show how use of these tests can help avoid the need for more invasive testing in the majority of children.
Non-invasive tests such urine studies, uroflowmetry ± simultaneous electromyography, assessment of post-void residual, renal/bladder ultrasound, and pelvic ultrasound when used appropriately can provide valuable information to facilitate decision making during the evaluation of children with LUTD. While these tests should be employed prior to more invasive testing such as urodynamic studies, they can often act as a surrogate for the more invasive tests. Non-invasive tests can help us in our goal of improving diagnostic ability to better classify the child's LUTD into an actual condition which allows targeted treatment in the hope of better outcomes and more satisfied patients and families.
下尿路功能障碍（LUTD）的症状，包括尿失禁、尿频和尿急，是儿童被转诊至小儿泌尿科医生处的最常见原因。尽管如此，LUTD的检查通常耗时，且让患者、家长和临床医生都感到沮丧。在本综述中，我们总结了非侵入性检查在LUTD患儿诊断和管理中的重要作用，并展示如何使用这些检查有助于在大多数儿童中避免进行更具侵入性的检查。
非侵入性检查，如尿液检查、尿流率测定±同步肌电图、排尿后残余尿量评估、肾脏/膀胱超声以及适当情况下的盆腔超声，在评估LUTD患儿时，若合理使用，可提供有价值的信息以辅助决策。虽然这些检查应在诸如尿动力学检查等更具侵入性的检查之前进行，但它们常常可替代更具侵入性的检查。非侵入性检查有助于我们提高诊断能力，以便更好地将儿童的LUTD归类为实际病症，从而进行有针对性的治疗，期望获得更好的结果以及让患者和家庭更满意。
