Affiliate Member in the Associação Brasileira de Estomaterapia (SOBEST), São Paulo, SP, Brazil; Universidade de Brasília (UnB), Departamento de Enfermagem, Brasília, DF, Brazil; Universidade Federal do Paraná (UFPR), Hospital de Clínicas (HC), Equipe de Estomaterapia, Curitiba, PR, Brazil.
Affiliate Member in the Associação Brasileira de Estomaterapia (SOBEST), São Paulo, SP, Brazil; Pontifícia Universidade Católica do Paraná (PUC/PR), Pós-graduação em Estomaterapia, Curitiba, PR, Brazil.
J Pediatr (Rio J). 2019 Nov-Dec;95(6):628-641. doi: 10.1016/j.jped.2019.02.007. Epub 2019 Apr 19.
To identify and describe the protocols and clinical outcomes of urotherapy interventions in children and adolescents with bladder bowel dysfunction.
Systematic review carried out in June 2018 on Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL),Excerpta Medica dataBASE (EMBASE), Scientific Electronic Library Online (SciELO), Cochrane Library, and PsycInfo databases. Clinical trials and quasi-experimental studies carried out in the last ten years in children and/or adolescents with bladder and bowel symptoms and application of at least one component of urotherapy were included.
Thirteen clinical trials and one quasi-experimental study were included, with moderate methodological quality. The heterogeneity of the samples and of the methodological design of the articles prevented the performance of a meta-analysis. The descriptive analysis through simple percentages showed symptom reduction and improvement of uroflowmetry parameters. The identified urotherapy components were: educational guidance, water intake, caffeine reduction, adequate voiding position, pelvic floor training, programmed urination, and constipation control/management.
This review indicates positive results in terms of symptom reduction and uroflowmetry parameter improvement with standard urotherapy as the first line of treatment for children and adolescents with bladder bowel dysfunction. It is recommended that future studies bring contributions regarding the frequency, number, and time of urotherapy consultations.
确定和描述膀胱肠功能障碍儿童和青少年尿动力学干预的方案和临床结果。
2018 年 6 月对 Medline、Cumulative Index to Nursing and Allied Health Literature（CINAHL）、Excerpta Medica dataBASE（EMBASE）、Scientific Electronic Library Online（SciELO）、Cochrane Library 和 PsycInfo 数据库进行系统评价。纳入了过去十年中针对膀胱和肠道症状的儿童和/或青少年进行的临床试验和准实验研究，并应用了至少一种尿动力学治疗组件。
纳入了 13 项临床试验和 1 项准实验研究，方法学质量中等。样本和文章的方法设计的异质性使得无法进行荟萃分析。通过简单百分比的描述性分析显示症状减轻和尿流率参数改善。确定的尿动力学治疗组件包括：教育指导、水分摄入、减少咖啡因、适当的排尿体位、盆底训练、定时排尿和便秘控制/管理。
本综述表明，对于膀胱肠功能障碍的儿童和青少年，标准的尿动力学治疗作为一线治疗方法，可以在减轻症状和改善尿流率参数方面取得积极效果。建议未来的研究在尿动力学治疗的咨询频率、次数和时间方面提供更多的贡献。
