PDF(Pubmed)
Abstract：
Lower urinary tract dysfunction is clinically important because it may cause urinary tract infections, mainly due to accumulation of residual urine, and adversely affect renal function. In addition, it may cause urinary incontinence, strongly affecting the child\'s quality of life. The function of the lower urinary tract is closely associated with function of the bowel because constipation is commonly present with bladder dysfunction. The interplay between the lower urinary tract and bowel function, coupled with common conditions such as detrusor overactivity and voiding dysfunction, requires a nuanced diagnostic approach. Detrusor overactivity, a benign but socially harmful condition, is the principal cause of daytime urinary incontinence in childhood. It needs to be differentiated from more serious conditions such as neurogenic bladder dysfunction or urethral obstruction. Voiding dysfunction, a habitual sphincter contraction during voiding, is common in children with detrusor overactivity and may be self limiting but may also result in residual urine and urinary tract infections. It may resemble, in severe cases, neurogenic bladder dysfunction, most often caused by spinal dysraphism, which very often leads to recurrent urinary tract infections and high intravesical pressures, jeopardizing renal function. A voiding diary is crucial in the initial evaluation of lower urinary tract function in children.
摘要：
下尿路功能障碍在临床上很重要，因为它可能导致尿路感染，主要是由于残余尿液的积累，并对肾功能产生不利影响。此外,它可能会导致尿失禁，严重影响孩子的生活质量。下尿路的功能与肠功能密切相关，因为便秘通常伴随膀胱功能障碍。下尿路和肠道功能之间的相互作用，再加上常见的情况，如逼尿肌过度活动和排尿功能障碍，需要细致入微的诊断方法。逼尿肌过度活动,一种良性但对社会有害的疾病，是儿童日间尿失禁的主要原因。需要将其与更严重的疾病区分开来，例如神经源性膀胱功能障碍或尿道阻塞。排尿功能障碍,在排尿时习惯性的括约肌收缩,在逼尿肌过度活动的儿童中很常见，可能是自限性的，但也可能导致残余尿液和尿路感染。它可能类似于，在严重的情况下，神经源性膀胱功能障碍，最常见的原因是脊柱发育不良，这通常会导致尿路感染复发和膀胱内压高，危及肾功能.排尿日记对于儿童下尿路功能的初步评估至关重要。
