Loening-Baucke V
Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Pediatrics. 1997 Aug;100(2 Pt 1):228-32. doi: 10.1542/peds.100.2.228.
To evaluate the frequency of urinary incontinence and urinary tract infection in children with chronic constipation and report on the resolution of these with treatment of the underlying constipation.
We evaluated the frequency of urinary incontinence and urinary tract infection in 234 chronic constipated and encopretic children before, and at least 12 months after, the start of treatment for constipation.
Twenty-nine percent complained of daytime urinary incontinence and 34% of nighttime urinary incontinence. Urinary tract infection was present in 11% and was more commonly present in girls than in boys (33% vs 3%). Vesicoureteral reflux was present in four and megacystis in four of the 25 children who had a voiding cystourethrogram because of urinary tract infection. One girl who came in had constipation and acute urinary retention. The treatment for constipation consisted of disimpaction and maintenance treatment, which included the prevention of reaccumulation of stools and reconditioning to normal bowel habits through timed toilet sitting. Follow-up, at least 12 months after start of treatment for constipation, revealed that the constipation was relieved successfully in 52%. Relief of constipation resulted in disappearance of daytime urinary incontinence in 89% and nighttime urinary incontinence in 63% of patients, and disappearance of recurrent urinary tract infections in all patients who had no anatomic abnormality of the urinary tract.
Urinary symptoms were found in a significant number of children who had functional constipation and encopresis. With treatment of the constipation, most patients became clean and dry and further recurrence of urinary tract infections was prevented.
评估慢性便秘儿童尿失禁和尿路感染的发生率，并报告随着潜在便秘的治疗这些症状的缓解情况。
我们评估了234名慢性便秘和遗粪症儿童在便秘治疗开始前以及开始治疗至少12个月后的尿失禁和尿路感染发生率。
29%的儿童主诉白天尿失禁，34%主诉夜间尿失禁。尿路感染发生率为11%，女孩比男孩更常见（33%对3%）。在因尿路感染进行排尿性膀胱尿道造影的25名儿童中，4名有膀胱输尿管反流，4名有巨膀胱。一名前来就诊的女孩既有便秘又有急性尿潴留。便秘治疗包括解除粪块嵌塞和维持治疗，维持治疗包括防止粪便再次积聚以及通过定时坐便训练恢复正常排便习惯。在便秘治疗开始至少12个月后的随访显示，52%的便秘得到成功缓解。便秘缓解后，89%的患者白天尿失禁消失，63%的患者夜间尿失禁消失，并且所有无尿路解剖异常的复发性尿路感染患者的感染均消失。
在大量功能性便秘和遗粪症儿童中发现了泌尿系统症状。随着便秘的治疗，大多数患者变得干爽清洁，尿路感染进一步复发得到预防。
