Hoekx L, Wyndaele J J, Vermandel A
Department of Urology, University Hospital Antwerp, Edegem, Belgium.
J Urol. 1998 Sep;160(3 Pt 1):858-60. doi: 10.1016/S0022-5347(01)62821-0.
Not all children with primary nocturnal enuresis, an unstable detrusor and small bladder capacity can be treated successfully with anticholinergics and bladder drill. We report our use of bladder biofeedback in patients who did not respond to 3 months of such treatment.
A total of 24 patients (median age 10.4 years) were studied. For bladder biofeedback a transurethral catheter was placed and connected with a 3-way connector. The bladder was slowly filled through this catheter and the intravesical pressure could be seen on a vertical tube, which was also connected to the transurethral catheter. The perineal bulbar detrusor inhibiting reflex was used in cases of involuntary bladder contraction. During the day patients retained urine as long as possible and completed a micturition chart.
Of the 24 patients bed-wetting stopped completely in 17 and decreased in 6, and treatment failed in 1. All patients were followed for at least 6 months after treatment. There were 2 cases of recurrence in the group that was cured.
Intravesical biofeedback can successfully treat patients with refractory primary enuresis associated with unstable detrusor and small bladder capacity.
并非所有原发性夜间遗尿、逼尿肌不稳定且膀胱容量小的儿童都能通过抗胆碱能药物和膀胱训练成功治疗。我们报告了在接受3个月此类治疗无效的患者中使用膀胱生物反馈的情况。
共研究了24例患者（中位年龄10.4岁）。进行膀胱生物反馈时，放置一根经尿道导管，并通过一个三通接头连接。通过该导管缓慢充盈膀胱，膀胱内压力可在与之相连的垂直管上看到。在膀胱不自主收缩的情况下，利用会阴球部逼尿肌抑制反射。白天患者尽可能长时间憋尿，并完成排尿图表。
24例患者中，17例尿床完全停止，6例减少，1例治疗失败。所有患者治疗后至少随访6个月。治愈组有2例复发。
膀胱内生物反馈可成功治疗与逼尿肌不稳定和膀胱容量小相关的难治性原发性遗尿症患者。
