Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0029713 (immaturity)
 4,335 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

After a description of the bladder-sphincter system physiology and of the different stages in the acquisition of micturition control by children, as revealed by urodynamic explorations, the author presents the bladder immaturity syndrome. This entity includes diurnal disorders of micturition--such as urgencies, pollakiuria, more seldom retention and incontinence--which can readily be identified by questioning. It accounts for many cases of nocturnal enuresis which may benefit from treatment with anticholinergic drugs. Nocturnal enuresis without disorders of micturition in daytime is due to other physiopathological mechanisms. It is preferably treated with tricyclic antidepressants and other non-medicinal therapies. All cases should be investigated for a possible organic pathology. A practical classification of enuresis is given.
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PMID:[Enuresis: the viewpoint of the urologist]. 291 63

Acquisition of control of micturition in children involves several stages, the most critical being the bladder immaturity phase. Although the passage from bladder automatism of the neonate to coordinated conscious bladder-sphincter activity in adults is usually a problem-free period, it is nevertheless a critical and sometimes dangerous phase in certain subjects. Purely functional disorders may induce, above a certain physiological limit, a true pathologic state considered up to the present as being organic in nature and requiring urodynamic exploration to confirm their individuality. This bladder immaturity syndrome has the common denominator of diurnal or nocturnal urine leaking, sometimes with an associated lower urinary tract infection in young girls. The first part of this review discusses a clinical trial conducted in 1 097 children (840 girls, 257 boys) age 4 to 15 years, with the "urine-leaking" symptom, divided into 2 groups as a function of its diurnal or nocturnal prevalence: Group I: diurnal incontinence alone: 285 children Group II: diurnal and nocturnal incontinence: 812 children Investigations included: a clinical examination including a full past history to determine possible infectious origin, the primary or secondary nature of the disorder, possible family history and particularly any associated diurnal micturitional disorders such as pollakiuria and urgency; cytobacteriology of urine; an I.V.U. reduced to a minimum of images; cystography and micturitional study; cystometry. Results in each group were expressed analytically, and showed assimilation of the 2 groups, having in common the incontinence-urine leaking symptom, whether it occurred during the day or night, with the diurnal manifestations of pollakiuria and urgency. This clinical feature derived from simple questioning was accompanied in 9 out of 10 cases by cystographic anomalies (notched bladder outline, modified proximal urethra in young girls, sometimes vesico-renal reflux) and cystometric changes (vesical hyperactivity and hypersensitivity). These findings provide better understanding of the significance of these clinical manifestations and their place within the framework of the urinary bladder immaturity syndrome. After a summary of the physiology of the bladder-sphincter apparatus and the stages of acquisition of micturitional control, with definition successively of the automatic, immature and adult bladder, the second part of the report discusses the urinary bladder immaturity syndrome itself. Symptoms are dependent on the urodynamic factors involved.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The bladder immaturity syndrome. Apropos of 1097 cases]. 407 51