Johnston J H, Koff S A, Glassberg K I
Br J Urol. 1978 Dec;50(7):505-10. doi: 10.1111/j.1464-410x.1978.tb06201.x.
In a minority of enuretic children with severe day symptoms, and especially when there is urinary infection, there a bladder diverticula and trabeculation and possbily also harmful vesicoureteric reflux which suggest the presence of an infravesical obstruction. However, in 11 children with this syndrome who underwent urodynamic studies, no anatomical or functional obstruction was demonstrable. It is contended that the obstructive signs are the result of uninhibited detrusor contractions being voluntarily resisted by contraction of the external urethral sphincter so that abnormallay high intravesical pressures result. Management involves the use of detrusor-inhibitory drugs. Ureteric reimplantation may be needed for reflux. In the majority of cases symptoms improve with time but the bladder diverticula persist.
在少数有严重日间症状的遗尿儿童中，尤其是存在泌尿系统感染时，会出现膀胱憩室、小梁形成，还可能存在有害的膀胱输尿管反流，这提示存在膀胱下梗阻。然而，在11例患有该综合征并接受尿动力学研究的儿童中，未发现解剖学或功能性梗阻。有人认为，梗阻迹象是由于尿道外括约肌收缩主动抵抗逼尿肌无抑制性收缩，从而导致膀胱内压力异常升高。治疗包括使用抑制逼尿肌的药物。对于反流可能需要进行输尿管再植术。在大多数情况下，症状会随时间改善，但膀胱憩室会持续存在。
