Çocuklarda idrar enkontinansı

İdrar enkontinansı çocukluk çağında sık karşılaşılan bir sorundur ve istemsiz idrar kaçırma olarak tanımlanır. Bilinen en önemli nedenleri; mesanenin olgunlaşmasındaki yetersizlik, tuvalet eğitimi sırasındaki yanlış davranışlar, idrar yolu enfeksiyonları, alt üriner sisteme ait anatomik bozukluklar ve sinirsel sorunlardır. Çocukluk çağında sinirsel olmayan nedenlere bağlı idrar kaçırmalar daha sıktır. İşeme bozukluğunun idrar yolu enfeksiyonu ve vezikoüreteral reflü ile ilişkisi iyi bilinmektedir. Etiolojinin ve doğru tedavi seçeneğinin belirlenebilmesi için ayrıntılı değerlendirme gerekmektedir.

Urinary incontinence in children

Urinary incontinence which is defined as the involuntary loss of urine is a very common clinical problem in childhood. Its etiology includes delayed bladder control, effects of environmental and social factors on toilet training, urinary tract infection, anatomic abnormalities of lower urinary tract and neurogenic disorders. The more common cause of childhood urinary incontinence is non-neurogenic abnormalities classified as anatomic abnormalities or bladder dysfunction. Voiding dysfunction is associated with vesicoureteral reflux and urinary infection. Diagnostic evaluation is essential to differentiate the causes of urinary incontinence and to determine the best therapy.

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  • 1. Butler RJ, Golding J, Northstone K; ALSPAC Study Team. Nocturnal enuresis at 7.5 years old: prevalence and analysis of clinical signs. BJU Int 2005; 96: 404–10.
  • 2. Nevéus T, Von Gontard A, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: Report from the Standardization Committee of the International Children’s Continence Society. J Urol 2006; 176: 314.
  • 3. Herndon CAD, Joseph DB. Urinary incontinence. Ped Clin N Am 2006; 53: 363 77.
  • 4. McLellan DL, Bauer SB. Bladder dysfunction. In: Avner ED, Harmon WE, Nıaduet P (eds). Pediatric Nephrology. Philedelphia: Lippincot Williams&Wilkins, 2004: 1077–90.
  • 5. Hoebeke P, Van Laecke E, Van Camp C, Raes A, Van De Walle J. One thousand video-urodynamic studies in children with non-neurogenic bladder sphincter dysfunction. BJU Int 2001; 87: 575-80.
  • 6. Schulman SL. Voiding dysfunction in children. Urol Clin N Am 2004; 31: 481 90.
  • 7. Cole EE, Dmochowski RR. Office urodynamics. Urol Clin N Am 2005; 32: 353 70.
  • 8. Sureshkumar P,Bower W, Craig JC, et al. Treatment of daytime urinary incontinence in children: a systematic review of randomized controlled trials. J Urol 2003; 170: 196-200.
  • 9. Schulman SL, Quinn CL, Plachter N, Kodman-Jones C. Comprehensive management of dysfunctional voiding. Pediatrics 1999; 103 : E31.
  • 10. Van Arendonk KJ, Austin C, Boyt M, Cooper CS. Frequency of wetting is predictive of response to anticholinergic treatment in children with overactive bladder. Urol 2006; 67: 1049–53.
  • 11. Kılıc N, Balkan E, Akgöz S, Sen N, Dogruyol H. Comparison of effectiveness and side-effects of tolterodine and oxybutynin in children with detrusor instability. Int J Urol 2006; 13: 105–8.
  • 12. Vasconcelos M, Lima E, Caiafa L, et al. Voiding dysfunction in children. Pelvic-floor exercises or biofeedback therapy: a randomized study. Pediatr Nephrol 2006; 21: 1858–64.
  • 13. Frenkl TL, Rackley RR. Injectable neuromodulatory agents: botulinum toxin therapy. Urol Clin N Am 2005; 32: 89–99.