Webster G D, el-Mahrouky A, Stone A R, Zakrzewski C
Br J Urol. 1986 Jun;58(3):261-5. doi: 10.1111/j.1464-410x.1986.tb09051.x.
The urological evaluation and results of management of 183 myelodysplastic patients are presented. Our management protocol stresses upper tract and infection status surveillance during the early childhood years, and a clean intermittent catheterisation programme with pharmacological manipulation of detrusor and sphincter function as the optimal later management. Continence failures are few and are manageable by sphincter prosthetic surgery or bladder augmentation. Urodynamic results are valuable in children with difficult incontinence or poor upper tracts. The intermittent catheterisation programme reduces the incidence of symptomatic urinary infections in these patients, but the incidence of asymptomatic bacteriuria is high. The adverse results of supravesical diversion in myelodysplastic children rarely justify its use.
本文介绍了183例骨髓发育异常患者的泌尿外科评估及治疗结果。我们的治疗方案强调在儿童早期对上尿路和感染状况进行监测，并采用清洁间歇性导尿方案，同时对逼尿肌和括约肌功能进行药物调节，作为最佳的后期治疗方法。尿失禁的情况很少见，可通过括约肌修复手术或膀胱扩大术进行处理。尿动力学检查结果对尿失禁难治或上尿路状况不佳的儿童很有价值。间歇性导尿方案降低了这些患者有症状性尿路感染的发生率，但无症状菌尿的发生率较高。在骨髓发育异常儿童中，膀胱上引流的不良后果很少证明其使用的合理性。
