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Bladder Dysfunction and Vesicoureteral Reflux英文文献资料.doc

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Bladder Dysfunction and Vesicoureteral Reflux英文文献资料

HindawiPublishingCorporation AdvancesinUrology Volume2008,ArticleID815472,8pages doi:10.1155/2008/815472 ReviewArticle BladderDysfunctionandVesicoureteralRe?ux UllaSille′n PediatricUronephrologicCenter(PUNC),QueenSilviaChildren’sHospital,TheSahlgrenskaAcademyatUniversityofGothenburg, 41685Gothenburg,Sweden CorrespondenceshouldbeaddressedtoUllaSill′en,ulla.sillen@vgregion.se Received3June2008;Accepted16September2008 RecommendedbyHiepNguyen Inthisoverviewthein?uenceoffunctionalbladderdisturbancesandofitstreatmentontheresolutionofvesicoureteralre?ux (VUR)inchildrenisdiscussed.Historicallybothbladderdysfunctionentities,theoveractivebladder(OAB)andthedysfunctional voiding(DV),havebeendescribedinconjunctionwith VUR.Treatmentofthedysfunctionwasalsoconsideredtoin?uence spontaneousresolutioninapositiveway.Duringthelastdecades,however,papershavebeenpublishedwhichcouldnotsupport theseresults.RegardingtheOAB,aprospectivestudywithtreatmentofthebladderoveractivitywithanticholinergics,didnot in?uencespontaneousresolutionrateinchildrenwithadysfunctionincludingalsothevoidingphase,DVandDES(dysfunctional eliminationsyndrome),moststudiesindicateanegativein?uenceontheresolutionrateofVURinchildren,bothbeforeandafter theageforbladdercontrol,bothwithandwithouttreatment.However,acoupleofuncontrolledstudiesindicatethatthereisa highshort-termresolutionrateaftertreatmentwith?owbiofeedback.Itshouldbeemphasizedthatthevoidingphasedysfunctions (DVandDES)aremoreseverethanthegenuine?llingphasedysfunction(OAB),withanincreasedfrequencyofUTIandrenal damageintheformergroups.Tobeabletoanswerthequestioniftreatmentofbladderdysfunctionin?uencetheresolutionrate ofVURinchildren,randomizedcontrolledstudiesmustbeperformed. Copyright?2008UllaSill′en.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense,which permitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. 1. INTRODUCTION positivelyin?uencedresolutionofthere?ux.Duringthelast deca