소아 기능성 요실금의 진단과 치료 = Diagnosis and therapy for functional urinary incontinence in childhood

다국어 초록 (Multilingual Abstract)

Functional urinary incontinence, the absence of any neurologic or structural abnormality as a cause of urinary incontinence in children, is one of the most common clinical problems encountered in pediatric and urologic departments, and it can be socially and emotionally distressing for the affected children. The prevalence rates of functional urinary incontinence in school-aged children are not very high and differ between boys and girls. The underlying mechanisms of functional urinary incontinence are heterogenous and can be associated with the following dysfunctions of both the storage and voiding patterns of the bladder: overactive bladder, dysfunctional voiding, lazy bladder syndrome, HinmanAllen syndrome, giggle incontinence, and vaginal voiding. Treatment methods for urinary incontinence in children should be chosen according to these clinical conditions. Treatment modalities generally consist of the treatment of comorbid conditions such as urinary infection and constipation, behavior therapy to modify learned voiding patterns, and pharmacotherapy primarily with anticholinergics and α-adrenergic blockers. This review discusses the optimal treatment modalities, including treatment of the underlying voiding disorders, and diagnostic approaches related to functional urinary incontinence in children.

참고문헌 (Reference)

1 Austin PF, "a-Adrenergic blockade in children with neuropathic and nonneuropathic voiding dysfunction" 162 : 1064-1067, 1999

2 Loening-Baucke V, "Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood" 100 : 228-232, 1997

3 Sureshkumar P, "Treatment of daytime urinary incontinence in children: a systematic review of randomized controlled trials" 170 : 196-200, 2003

4 Nijman RJ, "Tolterodine treatment for children with symptoms of urinary urge incontinence suggestive of detrusor overactivity: results from 2 randomized, placebo controlled trials" 173 : 1334-1339, 2005

5 Deluca FG, "The dysfunctional lazy bladder syndrome in children" 37 : 117-121, 1962

6 Sher PK, "Successful treatment of giggle incontinence with methylphendiate" 156 : 656-658, 1996

7 Nørgaard JP, "Standardization and definitions in lower urinary tract dysfunction in children. International Children's Continence Society" 81 (81): s1-s16, 1998

8 Bauer SB, "Special considerations of the overactive bladder in children" 60 : 43-49, 2002

9 Raes A, "Retrospective analysis of efficacy and tolerability of tolterodine in children with overactive bladder" 45 : 240-244, 2004

10 Hellström AL, "Rehabilitation of the dysfunctional bladder in children: method and 3-year followup" 138 : 847-849, 1987

11 Smellie JM, "Prophylactic co-trimoxazole and trimethoprim in the management of urinary tract infection in children" 2 : 12-17, 1988

12 Erickson BA, "Polyethylene glycol 3350 for constipation in children with dysfunctional elimination" 170 : 1518-1520, 2003

13 Appel RA, "Oxybutynin. The clinical experience" 3 : 60-67, 1991

14 Wehby MC, "Occult tight filum terminale syndrome: results of surgical untethering" 40 : 51-58, 2004

15 Saedi NA, "Natural history of voiding dysfunction" 18 : 894-897, 2003

16 Hellström AL, "Micturition habits and incontinence in 7-year-old Swedish school entrants" 149 : 434-437, 1990

17 Wiener JS, "Long-term efficacy of simple behavioral therapy for daytime wetting in children" 164 : 786-790, 2000

18 Wiener JS, "Long-term efficacy of simple behavioral therapy for daytime wetting in children" 164 : 786-790, 2000

19 Ayan S, "Efficacy of tolterodine as a first-line treatment for non-neurogenic voiding dysfunction in children" 96 : 411-414, 2005

20 Kim KM, "Efficacy and Tolerability of Tolterodine Compared to Oxybutynin in Children with a Neurogenic Bladder" 46 : 598-603, 2005

21 Fouron JC, "ECG changes in fatal imipramine (Tofranil) intoxication" 48 : 777-781, 1971

22 Kramer SA, "Double-blind placebo controlled study of a-adrenergic receptor antagonists (doxazosin) for treatment of voiding dysfunction in the pediatric population" 173 : 2121-2124, 2005

23 Allen HA, "Cooper CS. Initial trial of timed voiding is warranted for all children with daytime incontinence" 69 : 962-965, 2007

24 Bauer SB, "Campbell's Urology. 8th Ed" W.B. Saunders Co 2231-2283, 2002

25 van Gool JD, "Bladder-sphincter dysfunction, urinary infection and vesico-ureteral reflux with special reference to cognitive bladder training" 39 : 190-210, 1984

26 Goode PS, "Behavioral and drug therapy for urinary incontinence" 63 : s58-s64, 2004

27 Hoebeke P, "Assessment of lower urinary tract dysfunction in children with nonneuropathic bladder sphincter dysfunction" 35 : 57-69, 1999

28 Andersson KE, "Antimuscarinics for treatment of overactive bladder" 3 : 46-53, 2004

29 Cain MP, "Alpha blocker therapy for children with dysfunctional voiding and urinary retention" 170 : 1514-1517, 2003