The Uninhibited Bladder in Children: Effect of Treatment on Recurrence of Urinary Infection and on Vesicoureteral Reflux Resolution

Koff, Stephen A.; Murtagh, Daniel

doi:10.1016/s0022-5347(17)51725-5

Cited by 187 publications

(57 citation statements)

References 13 publications

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“…Normalization of the voiding process is also the goal for bladder training, most often used in children with unstable bladder (Hellstrøm et al, 1987). This training is expected to reduce residual urine and thereby the recurrence rate of cystitis (Koff and Murtagh, 1983). We found parallel changes in our material, with a statistical reduction in the residual urine among the treated patients with a Kidney yang/qi xu.…”

Section: Discussionmentioning

confidence: 52%

The Effect of Prophylactic Acupuncture Treatment in Women with Recurrent Cystitis: Kidney Patients Fare Better

Alræk

Bærheim

2003

The Journal of Alternative and Complementary Medicine

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Objective: To evaluate how the effect of acupuncture treatment in recurrent cystitis relates to Traditional Chinese Medicine (TCM) diagnostic categories and physiologic measurements.Setting/location: Two private acupuncture clinics in Bergen, Norway. Measurements were carried out in Haukeland University Hospital, Bergen.Design and subjects: Ninety-eight (98) cystitis-prone women were randomly assigned to acupuncture treatment or no treatment. Main effect parameter was number of cystitis during 6 months observation time. Residual urine was measured with an automatic Bladder Scan 2500 (Diagnostic Ultrasound Corporation, Bothell, WA) at baseline, 2, 4 and 6 months.Results: Twenty-two (22) patients had Spleen yang/qi xu (Sp), 18 Kidney yang/qi xu (Kid), and 18 Liver qi stagnation (Liv). Of the Kid group, 78% were free of cystitis (irrespective of bacteriuria) during the observation period compared to 45% in the Sp group, 44% in the Liv group (p # 0.05, Kid versus Sp and Liv), and 17% in the nontreated group (p # 0.01, versus all treated patients). One sixth as many episodes of acute cystitis occurred in the Kid group compared to the nontreated group (incidence rate ratio [IRR] Kid patients significantly reduced their residual urine from baseline to 6 months (36.4 mL versus 12.9 mL, p # 0.05). The reduction was less and nonsignificant in Sp and Liv groups (31.5 mL versus 22.2 mL, 36.4 mL versus 16.7 mL, respectively). Residual urine remained unchanged among nontreated patients.Conclusion: Our findings show a better acupuncture treatment effect on Kidney yang/qi xu than on other TCM syndromes found in women with recurrent cystitis. This has practical implications, and highlights the need for considering different TCM diagnostic categories in acupuncture research. 651

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Section: Discussionmentioning

confidence: 52%

The Effect of Prophylactic Acupuncture Treatment in Women with Recurrent Cystitis: Kidney Patients Fare Better

Alræk

Bærheim

2003

The Journal of Alternative and Complementary Medicine

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“…14,15 Even when children with severe dysfunctional voiding and urge incontinence were excluded, still about 20% of children with primary VUR were thought to have bladder/sphincter dysfunction. 16 Urodynamic investigations in infants with VUR revealed an interesting aspect of pathophysiology of VUR in this very young age group of children.…”

Section: Discussionmentioning

confidence: 99%

Diameter of the External Urethral Sphincter as a Predictor of Detrusor-Sphincter Incoordination in Children: Comparative Study of Voiding Cystourethrography

et al. 2003

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Underlying urological disease was primary vesicoureteral reflux in 57, congenital hydronephrosis in 9, urinary tract infection in 6, ureteral anomalies in 11, and others in 13.For the determination of EUSD in a given VCUG, EUSD was measured in consecutive films and the widest EUSD was chosen. (Part 2) Forty-three children with suspected voiding dysfunction underwent VCUG and sphincter electromyography (EUS-EMG). The findings of EUS-EMG were comparatively analyzed with EUSD.Results: (Part 1) Age-dependent increase in EUSD was seen in children with normal voiding function. EUSD (mm) was formulated as 0.166 x age (years) + 4.31 for boys (p=0.0001, r=0.374), and 0.222 x age (years) + 2.73 for girls (p<0.0001, r=0.595). Overall incidence of EUSD less than 3 mm was only 4% (8/200). (Part 2) EUS-EMG documented detrusor-sphincter incoordination in 15 children (35%). When we defined EUSD less than 3mm as a cut-off value for predicting detrusor-sphincter incoordination, the sensitivity, specificity, positive and negative predictive values were 93%, 89%, 82% and 96%, respectively.Conclusions: EUSD has a satisfactory sensitivity and specificity as a predictor of 2 detrusor-sphincter incoordination in children. Thus, simple measurement of EUSD on VCUG should be recommended in children with suspected voiding dysfunction before employing rather invasive urodynamic study.3

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“…Koff e Murtagh (1983) reportaram que o tratamento da HV, em crianças, usando agentes anticolinérgicos apresentou uma taxa de melhora ou cura dos sintomas em cerca de 60% dos casos 17 . As drogas comumente utilizadas são os antimuscarínicos, dentre eles o cloridrato de oxibutinina e a tolterodina, e entre seus efeitos estão a supressão de contrações involuntárias do detrusor, diminuição do tônus vesical e redução da frequência miccional.…”

Section: Medicaçãounclassified

Lower Urinary Tract Dysfunction in Children: Focus on Overactive Bladder

Lordêlo

Teles²

2017

RPF

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A disfunção do trato urinário inferior (DTUI) na infância apresenta alta prevalência, podendo levar a sintomas de urgência miccional, incontinência urinária, infecção do trato urinário, refluxo vesicoureteral, lesão renal, além de impactos psicoemocionais. A hiperatividade vesical (HV) é a forma mais comum de apresentação da DTUI, sendo caracterizada como uma alteração na fase de enchimento vesical, acompanhada por sintomas urinários próprios desta fase, mas com um padrão de fluxo urinário normal e sem apresentação de resíduo pós-miccional. A sua fisiopatologia ainda é controversa, e engloba possibilidades de alterações de origem central, de desencadeamento de contrações não inibidas do detrusor devido ao quadro de constipação intestinal, ou ainda a possibilidade de ser causada pelo quadro de infecção do trato urinário. Há três principais tratamentos disponíveis para tratar crianças com HV: medicação, uroterapia e eletroestimulação. Destes, a terapia medicamentosa ainda é a mais difundida pelo mundo, apesar de trazer diversos efeitos colaterais e baixa taxa de cura. A uroterapia é baseada em orientações miccionais e alimentares e deve ser indicada como a primeira linha terapêutica. A eletroestimulação ainda apresenta diversidade em relação à posição do eletrodo, tempo e frequência da aplicação e parâmetros diferentes em relação à corrente terapêutica. Apesar dessa variabilidade, as terapias combinadas da uroterapia com a eletroestimulação apresentam melhores resultados clínicos de acordo com os trabalhos disponíveis na literatura.

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The Uninhibited Bladder in Children: Effect of Treatment on Recurrence of Urinary Infection and on Vesicoureteral Reflux Resolution

Cited by 187 publications

References 13 publications

The Effect of Prophylactic Acupuncture Treatment in Women with Recurrent Cystitis: Kidney Patients Fare Better

The Effect of Prophylactic Acupuncture Treatment in Women with Recurrent Cystitis: Kidney Patients Fare Better

Diameter of the External Urethral Sphincter as a Predictor of Detrusor-Sphincter Incoordination in Children: Comparative Study of Voiding Cystourethrography

Lower Urinary Tract Dysfunction in Children: Focus on Overactive Bladder

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