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[Detrusor pseudohyperactivity syndrome in children with constipation]
Ryszard Makosiej1, Danuta Leśniak, Ewa Skłodowska
1Klinika Gastroenterologii, Instytut Centrum Zdrowia Matki Polki, ul. Rzgowska 281/289, 93-338 Lodz , Poland. kgp@iczmp.edu.pl
Insights
Chronic constipation in children can lead to detrusor hyperactivity syndrome, causing nocturia and daytime urinary incontinence. This occurs due to rectal pressure on the bladder, impacting its volume and function.
Area of Science:
- Pediatric Urology
- Gastroenterology
- Clinical Medicine
Background:
- Nocturia, pressing tenesmus, and daytime urinary incontinence are common pediatric urological issues.
- The interplay between constipation and lower urinary tract symptoms requires further investigation.
Purpose of the Study:
- To evaluate the relationship between constipation and symptoms of nocturia, pressing tenesmus, and daytime urinary incontinence in children.
- To understand the underlying mechanisms connecting constipation to these urinary symptoms.
Main Methods:
- A study involving 51 children (3-17 years) hospitalized for nocturia, pressing tenesmus, and daytime urinary incontinence.
- Comprehensive diagnostic workup of the urinary and lower alimentary tracts, with results compared to a control group.
Main Results:
- An enlarged rectal ampulla can decrease bladder volume, leading to pressing tenesmus, nocturia, and daytime urinary incontinence.
- This mechanism contributes to the development of detrusor hyperactivity syndrome, characterized by chronic constipation and altered voiding patterns.
Conclusions:
- Chronic constipation disrupts the functional balance between the distal bowel and bladder.
- This disruption contributes to the formation of detrusor hyperactivity syndrome, affecting urine storage and voiding.
The Aim Of The Study:
was the evaluation of dependencies occurring between constipation and observed nocturia, pressing tenesmus and daytime urinary incontinence.
Material And Methods:
the studies were conducted in 51 children aged between 3 and 17 years including 25 girls and 26 boys hospitalized in the Clinical Department because of nocturia, pressing tenesmus and daytime urinary incontinence. In all children a complex diagnostic work up of the urinary system and the lower segment of alimentary tract was performed. Results of the examinations were compared to the control group.
Results:
analysis of the results of the conducted examinations indicates that the overblown rectal ampulla, through the pressure exerted on the urinary bladder, seemingly decreases its volume causing the occurrence of pressing tenesmus, nocturia and daytime urinary incontinence. This process leads to the formation of detrusor hyperactivity syndrome characterized by: chronic constipation, increase of miction frequency and simultaneous decrease of volume of each portion of urine, nocturia and/or daytime urinary incontinence.
Conclusions:
chronic constipation disturbs the functional-morphological equilibrium between the end segment of alimentary tract and the urinary bladder. By influencing the process of filling and accumulation of urine in the bladder they lead to the formation of detrusor hyperactivity syndrome.
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