Öz
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 Türk Ped Arş 2007; 42: 133 5 Anahtar kelimeler: Çocukluk çağı enürezis idrar enkontinansı
Anahtar Kelimeler
Kaynakça
- Butler RJ, Golding J, Northstone K; ALSPAC Study Team. Noc- turnal enuresis at 7.5 years old: prevalence and analysis of clini- cal signs. BJU Int 2005; 96: 404–10.
- Nevéus T, Von Gontard A, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adoles- cents: Report from the Standardization Committee of the Internati- onal Children’s Continence Society. J Urol 2006; 176: 314.
- Herndon CAD, Joseph DB. Urinary incontinence. Ped Clin N Am ; 53: 363–77. McLellan DL, Bauer SB. Bladder dysfunction. In: Avner ED, Har- mon WE, Nıaduet P (eds). Pediatric Nephrology. Philedelphia: Lippincot Williams&Wilkins, 2004: 1077–90.
- Hoebeke P, Van Laecke E, Van Camp C, Raes A, Van De Walle J. One thousand video-urodynamic studies in children with non-ne- urogenic bladder sphincter dysfunction. BJU Int 2001; 87: 575-80.
- Schulman SL. Voiding dysfunction in children. Urol Clin N Am ; 31: 481–90. Cole EE, Dmochowski RR. Office urodynamics. Urol Clin N Am ; 32: 353–70. Sureshkumar P,Bower W, Craig JC, et al. Treatment of daytime urinary incontinence in children: a systematic review of randomi- zed controlled trials. J Urol 2003; 170: 196-200.
- Schulman SL, Quinn CL, Plachter N, Kodman-Jones C. Comp- rehensive management of dysfunctional voiding. Pediatrics ; 103 : E31. 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.
- 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.
- Vasconcelos M, Lima E, Caiafa L, et al. Voiding dysfunction in children. Pelvic-floor exercises or biofeedback therapy: a ran- domized study. Pediatr Nephrol 2006; 21: 1858–64.
- Frenkl TL, Rackley RR. Injectable neuromodulatory agents: bot- ulinum toxin therapy. Urol Clin N Am 2005; 32: 89–99.
- Tablo 2. İlaçla tedavide tercih edilecek ilaçlar ve dozları İlaçlar Doz En yüksek doz Antikolinerjikler Oxybutynin chloride Tolterodine tartrate ,2 mg/kg/gün ,02 mg/kg/gün ,6mg/kg/gün mg 2 kez Alfa adrenerjik blokerler Prazosin Doxazosin ,1mg/kg/gün ,5 mg ,5 mg/kg/gün –2 mg Antibiyotikler (profilaksi) Nitrofurantoin TMP-SMX Cefixime mg/kg/doz mg/kg/doz (TMP) mg/kg/doz mg/doz mg/doz mg/doz Kabızlık tedavisi Polyethylene glycol Lactulose Mineral yağlar <5 yaş; 8,5 gr, >5yaş: 16gr ml, po 2 yemek kaşığı
Öz
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 nbsp; Turk Arch Ped 2007; 42: 133 5 Key words: Childhood enuresis urinary incontinence
Anahtar Kelimeler
Kaynakça
- Butler RJ, Golding J, Northstone K; ALSPAC Study Team. Noc- turnal enuresis at 7.5 years old: prevalence and analysis of clini- cal signs. BJU Int 2005; 96: 404–10.
- Nevéus T, Von Gontard A, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adoles- cents: Report from the Standardization Committee of the Internati- onal Children’s Continence Society. J Urol 2006; 176: 314.
- Herndon CAD, Joseph DB. Urinary incontinence. Ped Clin N Am ; 53: 363–77. McLellan DL, Bauer SB. Bladder dysfunction. In: Avner ED, Har- mon WE, Nıaduet P (eds). Pediatric Nephrology. Philedelphia: Lippincot Williams&Wilkins, 2004: 1077–90.
- Hoebeke P, Van Laecke E, Van Camp C, Raes A, Van De Walle J. One thousand video-urodynamic studies in children with non-ne- urogenic bladder sphincter dysfunction. BJU Int 2001; 87: 575-80.
- Schulman SL. Voiding dysfunction in children. Urol Clin N Am ; 31: 481–90. Cole EE, Dmochowski RR. Office urodynamics. Urol Clin N Am ; 32: 353–70. Sureshkumar P,Bower W, Craig JC, et al. Treatment of daytime urinary incontinence in children: a systematic review of randomi- zed controlled trials. J Urol 2003; 170: 196-200.
- Schulman SL, Quinn CL, Plachter N, Kodman-Jones C. Comp- rehensive management of dysfunctional voiding. Pediatrics ; 103 : E31. 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.
- 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.
- Vasconcelos M, Lima E, Caiafa L, et al. Voiding dysfunction in children. Pelvic-floor exercises or biofeedback therapy: a ran- domized study. Pediatr Nephrol 2006; 21: 1858–64.
- Frenkl TL, Rackley RR. Injectable neuromodulatory agents: bot- ulinum toxin therapy. Urol Clin N Am 2005; 32: 89–99.
- Tablo 2. İlaçla tedavide tercih edilecek ilaçlar ve dozları İlaçlar Doz En yüksek doz Antikolinerjikler Oxybutynin chloride Tolterodine tartrate ,2 mg/kg/gün ,02 mg/kg/gün ,6mg/kg/gün mg 2 kez Alfa adrenerjik blokerler Prazosin Doxazosin ,1mg/kg/gün ,5 mg ,5 mg/kg/gün –2 mg Antibiyotikler (profilaksi) Nitrofurantoin TMP-SMX Cefixime mg/kg/doz mg/kg/doz (TMP) mg/kg/doz mg/doz mg/doz mg/doz Kabızlık tedavisi Polyethylene glycol Lactulose Mineral yağlar <5 yaş; 8,5 gr, >5yaş: 16gr ml, po 2 yemek kaşığı
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Türkçesi Varken |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Aralık 2007 |
| Yayımlandığı Sayı | Yıl 2007 Cilt: 42 Sayı: 4 |