Holschneider A M, Kraeft H, Scholtissek C
Z Kinderchir. 1982 Feb;35(2):64-8. doi: 10.1055/s-2008-1059904.
104 children with imperforate anus and 68 children with megacolon congenitum were subjected to careful analysis in respect of postoperative incontinence of urine. This was observed in 20 patients with imperforate anus (19.2%) and 15 patients with Hirschsprung's disease (22%). In children with imperforate anus urine incontinence showed a slight tendency only to spontaneous cure. For example, 19.1% of the children with imperforate anus still showed signs of incontinence 11 years after the first operation. On the other hand, there was often a spontaneous cure of incontinence of urine in children with Hirschsprung's disease, so that 5.8% only of the patients had incontinence after the same period. The causes of incontinence are of a multifactorial nature. Rectourethral fistulas, which can damage the sphincter vesicae externus, play an important part. This is likewise true of sequel operations in the pelvis minor with iatrogenic lesions of the sacral nerve fibres; of associate malformations of the urogenital tract and of the vertebral column; and of chronic relapsing infections of the urinary tract caused by an accompanying encopresis (incontinence of faeces).
对104例肛门闭锁患儿和68例先天性巨结肠患儿的术后尿失禁情况进行了仔细分析。在20例肛门闭锁患儿（19.2%）和15例先天性巨结肠患儿（22%）中观察到了尿失禁。肛门闭锁患儿的尿失禁仅有轻微的自然治愈倾向。例如，19.1%的肛门闭锁患儿在首次手术后11年仍有尿失禁迹象。另一方面，先天性巨结肠患儿的尿失禁常常会自然治愈，因此在同一时期只有5.8%的患者有尿失禁。尿失禁的原因是多因素的。直肠尿道瘘会损伤膀胱外括约肌，起重要作用。骨盆小区域的后续手术伴有骶神经纤维的医源性损伤、泌尿生殖道和脊柱的相关畸形以及由伴随的大便失禁（粪便失禁）引起的慢性复发性尿路感染也是如此。
