Knebel L, Ludwig G
Fortschr Med. 1980 Apr 24;98(16):597-601.
Recurrent urinary tract infections, vesicoureteral reflux and enuresis in children want a detailed urologic evalution which often makes - in addition to obvious urinealysis, urine culture, excretory urography and voiding cystourethrography-extended diagnostics necessary including an urethral calibration to definitely exclude a distal urethral stenosis, and a cystoscopy under general anesthesia in order to reveal abnormalities of shape and placement of the ureteral orifice (e.g. lateral placement, "stadium", "horseshoe" or "golf-hole" shape). Then micturition urodynamic flow studies using a suprapubic cystocath are done to recognize an infravesical obstruction, a sphincter dyssynergia, an unstable bladder, an uninhibited bladder or a neurogenic bladder. All these examinations are imperative concerning the decision on either conservative (medical) or surgical treatment or both.
儿童复发性尿路感染、膀胱输尿管反流和遗尿需要进行详细的泌尿外科评估,这通常除了明显的尿液分析、尿培养、排泄性尿路造影和排尿性膀胱尿道造影外,还需要进行包括尿道扩张以明确排除远端尿道狭窄在内的进一步诊断,以及在全身麻醉下进行膀胱镜检查,以发现输尿管口形状和位置的异常(如外侧位置、“体育场”形、“马蹄”形或“高尔夫球洞”形)。然后使用耻骨上膀胱造瘘管进行排尿尿动力学流量研究,以识别膀胱下梗阻、括约肌协同失调、不稳定膀胱、无抑制膀胱或神经源性膀胱。所有这些检查对于决定采用保守(药物)治疗、手术治疗或两者兼用至关重要。