Kramer S A, Kelalis P P
J Pediatr Surg. 1981 Dec;16(6):812-6. doi: 10.1016/s0022-3468(81)80824-x.
Between 1946 and 1980, 54 patients with epispadias and total urinary incontinence were evaluated at our institution. Factors critical to the achievement of complete continence include deferral of surgery until at least 3 yr of age, the patient having a well-developed bladder with adequate capacity and musculature, and maturation of the prostate at puberty in males. Complete continence was obtained in 9 of 11 female patients (82%). Fourteen of 35 male patients obtained complete urinary continence in the initial postoperative period. Complete urinary control was delayed until puberty in 11 additional patients, for an overall success rate of 25 of 35 males (71%). The significant increase in continence with the onset of puberty in males demonstrates the importance of expectant management of the child's progress in relation to the potential contribution of prostatic maturation in the development of urinary control.
1946年至1980年间，我院对54例患有尿道上裂和完全尿失禁的患者进行了评估。实现完全控尿的关键因素包括手术推迟至至少3岁、患者膀胱发育良好且容量和肌肉组织充足，以及男性青春期前列腺成熟。11例女性患者中有9例（82%）实现了完全控尿。35例男性患者中有14例在术后初期实现了完全尿控。另有11例患者直到青春期才实现完全尿控，35例男性患者的总体成功率为25例（71%）。男性青春期开始后控尿率显著提高，这表明在儿童发育过程中，就前列腺成熟对尿控发展的潜在贡献而言，进行观察性管理非常重要。
