Edelstein R A, Bauer S B, Kelly M D, Darbey M M, Peters C A, Atala A, Mandell J, Colodny A H, Retik A B
Division of Urology, Children's Hospital, Boston, Massachusetts 02115, USA.
J Urol. 1995 Oct;154(4):1500-4.
Urinary tract management in children with myelodysplasia is controversial. Some advocate observation alone, while others believe that the prophylactic institution of intermittent catheterization and anticholinergic therapy may help to prevent deterioration.
A nonrandomized prospective study was instituted to compare the urological outcomes of a cohort of children who were at risk for urological deterioration on the basis of bladder-sphincter dyssynergia and/or high filling or voiding pressures. Those at risk were observed until deterioration occurred, or were placed on prophylactic intermittent catheterization with or without anticholinergic medication.
Of 44 children at risk 35 followed by observation alone had urinary tract deterioration, whereas only 3 of 20 at risk treated with prophylactic intermittent catheterization had deterioration with time.
Proactive bladder treatment significantly reduced the incidence of upper urinary tract deterioration and need for surgical intervention.
脊髓发育不良患儿的尿路管理存在争议。一些人主张仅进行观察，而另一些人则认为预防性实施间歇性导尿和抗胆碱能治疗可能有助于防止病情恶化。
开展一项非随机前瞻性研究，以比较一组因膀胱括约肌协同失调和/或高充盈压或排尿压力而有尿路恶化风险的儿童的泌尿学结果。对有风险的儿童进行观察，直至病情恶化，或者对其进行预防性间歇性导尿，同时或不同时使用抗胆碱能药物。
在44名有风险的儿童中，仅接受观察的35名儿童出现了尿路恶化，而在20名接受预防性间歇性导尿治疗的有风险儿童中，只有3名随着时间推移出现了恶化。
积极的膀胱治疗显著降低了上尿路恶化的发生率以及手术干预的必要性。
