NONNEUROGENIC VOIDING DYSFUNCTION IN CHILDREN: 10 YEARS EXPERIENCE IN A TERTIARY PEDİATRİC NEPHROLOGY CLINIC

Year 2024, Volume: 7 Issue: 2, 196 - 201, 30.06.2024

Belkıs İpekçi Kenan Bek

Abstract

Objective: In this study, we aimed to investigate the clinical and epidemiological features of children with voiding dysfunction admitted to our pediatric nephrology outpatient clinic within a 10- year period.
Method: Documents of all patients admitted to Kocaeli University pediatric nephrology outpatient clinic within the period between January 2002 and December 2011 were retrospectively reviewed and patients with a diagnosis of voiding dysfunction aged 5 to 18 years old at first admission were included in the study. Children with nocturnal enuresis without daytime symptoms, who had congenital anomalies or neurological problems that we detected, or neurological disorders that were known previously were excluded. Response to therapy was defined as the complete resolution of the symptoms.
Results: Files of 7463 patients were reviewed and 872 (11.6 %) patients with voiding dysfunction were included in the study. The mean age of patients 8.86 2.54 years and female to male ratio was 5:1, respectively. The frequency of previous urinary tract infections was 46 % with a mean annual attack rate of 3.05. The reduction of this figure to 1.72/ year following therapy of voiding dysfunction was statistically significant. The treatment response was significantly better in patients treated with a single modality.
Conclusion: Voiding dysfunction may lead to serious renal damage and chronic kidney disease through recurrent urinary tract infections, especially in children with urinary tract abnormalities. In most cases, this can be prevented by simple measures like urotherapy and/or anticholinergics. Thus educating parents and questioning all pediatric outpatient population about voiding dysfunction are critical.

Keywords

Voiding disorders, dysfunctional voiding, overactive detrusor in childhood

Project Number

KOU KAEK 2012119

ÇOCUKLARDA NÖROJENİK OLMAYAN İŞEME BOZUKLUKLARI: ÜÇÜNCÜ BASAMAK ÇOCUK NEFROLOJİ MERKEZİNDE 10 YILLIK DENEYİM

Abstract

Çalışmaya ait Türkçe Öz:
Amaç: Çalışmamızda geriye dönük 10 yıllık süreç içinde çocuk nefroloji bölümüne işeme disfonksiyonu ile başvurup takipte kalmış hastalarımızın klinik ve epidemiyolojik özelliklerini araştırarak sonrasında takip ettiğimiz hastaların takip sürecini revize etmeyi amaçladık.
Yöntem: Ocak 2002 ile Aralık 2011 tarihleri arasında Kocaeli Üniversitesi Çocuk Nefroloji polikliniğine ayaktan başvuran tüm hastalarının dosyaları geriye dönük olarak incelenerek 5-18 yaş arası işeme disfonksiyonu tanısı alan hastalar çalışmaya dahil edildi. Nörolojik muayenesinde patoloji olanlar, nörolojik hastalık tanısı olanlar, konjenital anomalisi olanlar, sadece gece idrar kaçırması olanlar çalışmaya dahil edilmedi. Tedaviye cevap semptomların tamamen düzelmesi olarak kabul edildi.
Bulgular: Yedi bin dört yüz altmış üç hasta dosyası incelenerek işeme disfonksiyonu olan 872 (% 11,6 ) hasta çalışmaya dahil edildi. Hastaların ortalama yaşı 8,86 2,54 yaş, kız erkek oranı 5:1 idi. Başvuru öncesi idrar yolu enfeksiyonu frekansı % 46,8, yıllık idrar yolu enfeksiyonu hızı 3,05 idi. Tedavi sonrası bu hızın 1,72 ye gerilemesi istatistiksel olarak anlamlı bulundu. Tedavi cevabı tek yöntemle tedavi alanlarda, standart üroterapi ve antikolinerjik beraber kullananlarda, aşikar olarak daha iyi bulundu.
Sonuç: İşeme disfonksiyonu özellikle çocuklarda tekrarlayan idrar yolu enfeksiyonuna neden olarak ciddi böbrek hasarı ve kronik böbrek hastalıklarına zemin hazırlayabilir. Birçok hasta üroterapi ve /veya antikolinerjik ilaçlar gibi basit yöntemlerle böbrek hasarı gelişmesinden korunabilir. Bu sebeple ailelerin eğitimi ve pediatrik hasta grubunda işeme disfonksiyonu semptomlarının sorgulanması önemlidir.

Keywords

İşeme bozukluğu, disfonksiyonel işeme, çocuklarda aşırı aktif mesane

Ethical Statement

Kocaeli Üniversitesi tıp fakültesi klinik araştırma etik kurul : KOU KAEK 2012119

Supporting Institution

yok

Project Number

KOU KAEK 2012119

Thanks

-

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