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儿童 COVID-19 后尿动力学证实的下尿路功能障碍:病例系列。

Urodynamically proven lower urinary tract dysfunction in children after COVID-19: A case series.

机构信息

Division of Pediatric Urology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Department of Urology, Koç University School of Medicine, Istanbul, Turkey.

出版信息

Low Urin Tract Symptoms. 2022 Jul;14(4):301-304. doi: 10.1111/luts.12436. Epub 2022 Mar 15.

Abstract

CASE

Since the declaration of COVID-19 as a pandemic, other unexpected symptoms related to the infection besides the respiratory system have been reported. Although a few case reports have revealed that adult patients with COVID-19 also complained of urinary frequency and nocturia, the exact pathophysiology is still unclear. In this case series, we present three children aged 14 to 17 years with urodynamically proven lower urinary tract dysfunction (LUTD) following COVID-19.

OUTCOME

None of the patients had constipation or bowel disorder before the diagnosis of COVID-19. In addition, neurological examination and related imaging revealed no signs of etiological factors. The median time from diagnosis of COVID-19 infection to the onset of lower urinary tract symptoms was 3 months. Incomplete bladder emptying/urinary retention supported by increased bladder compliance, high post-micturition residual urine volumes, and absence of detrusor pressure increase during the voiding phase in the pressure flow study (acontractile detrusor in two patients and hypocontractile detrusor in one patient) were observed.

CONCLUSION

We observed that LUTD (eg, incomplete bladder emptying, urinary retention) can be prominent some time after the diagnosis of COVID-19. Even though psychogenic or neurogenic causes may not be excluded completely, clinicians should be aware of a recent COVID-19 infection in children with sudden-onset LUTD.

摘要

病例

自 COVID-19 被宣布为大流行以来,除了呼吸系统之外,与感染相关的其他意外症状也有报道。尽管少数病例报告表明,患有 COVID-19 的成年患者也抱怨尿频和夜尿症,但确切的病理生理学仍不清楚。在本病例系列中,我们介绍了 3 名 14 至 17 岁的儿童,他们在 COVID-19 后经尿动力学证实存在下尿路功能障碍(LUTD)。

结果

在 COVID-19 诊断之前,这些患者均无便秘或肠道紊乱。此外,神经系统检查和相关影像学检查未发现病因因素的迹象。从 COVID-19 感染诊断到下尿路症状发作的中位时间为 3 个月。压力流研究中观察到膀胱顺应性增加、排尿后残余尿量增加和逼尿肌压力在排尿期无增加(两名患者为无收缩性逼尿肌,一名患者为低收缩性逼尿肌),提示存在不完全排空/尿潴留。

结论

我们观察到 LUTD(例如,不完全排空膀胱、尿潴留)可能在 COVID-19 诊断后一段时间内明显出现。即使不能完全排除心理或神经源性原因,临床医生也应该注意到儿童突然出现 LUTD 与近期 COVID-19 感染有关。

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