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[儿童下尿路功能障碍]

[Lower urinary tract dysfunction in children].

作者信息

Carvalho Tomas Alves Gil Beatriz, Grundl Sebastian, Saar Matthias, Kranz Jennifer

机构信息

Klinik für Urologie und Kinderurologie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.

Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland.

出版信息

Urologie. 2025 Feb;64(2):142-148. doi: 10.1007/s00120-024-02501-5. Epub 2025 Jan 14.

Abstract

Lower urinary tract dysfunction (LUTD) is common in children and can significantly impact the quality of life in affected children and their families. This article provides a comprehensive overview of the causes, diagnostics, and treatment, with a particular focus on nonorganic urinary incontinence and nocturnal enuresis. Accurate diagnostics are essential to differentiate between organic and functional causes, as well as to distinguish primary from secondary forms of urinary incontinence. Basic diagnostics, including medical history, physical examination, and voiding diaries, form the foundation, while specialized diagnostics such as uroflowmetry or imaging enhance the evaluation of complex cases. Treatment of functional LUTD is primarily conservative, involving behavioral interventions as part of urotherapy, supported by pharmacological options like desmopressin or anticholinergics. Effective therapy also requires addressing comorbid conditions, such as chronic constipation or psychological disorders. In this article, the importance of an interdisciplinary approach and individualized therapy to achieve lasting symptom improvement and enhanced quality of life is emphasized.

摘要

下尿路功能障碍(LUTD)在儿童中很常见,会对患病儿童及其家庭的生活质量产生重大影响。本文全面概述了其病因、诊断和治疗方法,特别关注非器质性尿失禁和夜间遗尿症。准确的诊断对于区分器质性和功能性病因以及区分原发性和继发性尿失禁形式至关重要。基本诊断,包括病史、体格检查和排尿日记,构成了基础,而诸如尿流率测定或影像学等专业诊断则有助于对复杂病例进行评估。功能性LUTD的治疗主要是保守治疗,包括作为尿疗一部分的行为干预,并辅以去氨加压素或抗胆碱能药物等药物治疗选择。有效的治疗还需要处理合并症,如慢性便秘或心理障碍。本文强调了采用跨学科方法和个体化治疗以实现症状持久改善和提高生活质量的重要性。

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