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DYSFUNCTIONAL ELIMINATION SYNDROME AS AN ETIOLOGY OF IDIOPATHIC URETHRITIS IN CHILDHOOD

2005; Lippincott Williams & Wilkins; Volume: 173; Issue: 6 Linguagem: Inglês

10.1097/01.ju.0000157686.28359.c7

1527-3792

Daniel Herz, Adam C. Weiser, THERESE COLLETTE, Edward F. Reda, Selwyn B. Levitt, Israel Franco,

Pediatric Urology and Nephrology Studies

No AccessJournal of UrologyPediatric Urology1 Jun 2005DYSFUNCTIONAL ELIMINATION SYNDROME AS AN ETIOLOGY OF IDIOPATHIC URETHRITIS IN CHILDHOOD DANIEL HERZ, ADAM WEISER, THERESE COLLETTE, EDWARD REDA, SELWYN LEVITT, and ISRAEL FRANCO DANIEL HERZDANIEL HERZ More articles by this author , ADAM WEISERADAM WEISER More articles by this author , THERESE COLLETTETHERESE COLLETTE More articles by this author , EDWARD REDAEDWARD REDA More articles by this author , SELWYN LEVITTSELWYN LEVITT More articles by this author , and ISRAEL FRANCOISRAEL FRANCO More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000157686.28359.c7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Idiopathic urethritis (IU) of childhood or urethrorrhagia is a common problem characterized by blood spotting in the underwear between voiding. A clear etiology has not been established and treatments vary. We postulate that idiopathic urethritis is a manifestation of underlying dysfunctional elimination syndrome (DES). Materials and Methods: During a 5-year period we reviewed the records of all children diagnosed with IU in our practice. In total 72 children fit the analysis criteria. There were 68 boys and 4 girls. All children presented with either gross blood per urethra or microhematuria. Children with active infection, immunodeficiency, neurogenic bladder, vesicoureteral reflux, infravesical obstruction, urethral trauma or other genitourinary anomalies were excluded. Evaluation included thorough history and physical examination, urinalysis and urine culture. Renal and bladder ultrasound, voiding cystourethrogram and uroflow/electromyogram/post-void residual volume were obtained in select patients. Study children were divided into 2 cohorts. The first cohort (group 1, 37 patients) was treated with traditional remedies using antibiotics, urinary analgesics and/or anticholinergics. The second cohort (group 2, 35 patients) was treated by bowel and bladder regimens, laxatives when necessary, and biofeedback and/or α-blockers when sphincter dyssynergia was identified. Results: A total of 13 patients in group 1 (35%) had a full response to treatment, 6 (16%) had a partial response and 18 (49%) failed to respond. A total of 29 patients in group 2 (83%) had a full response to treatment, 2 (6%) had a partial response and 4 (11%) had no response. It took an average of 12.1 months to respond fully in group 1, while in group 2 the same full response took an average of 5.2 months. Of the 18 children who crossed over from group 1 to group 2, 15 (83%) had a full response with an average response time of 7.3 months. Conclusions: Our data clearly reveal a higher cure rate when children with urethritis are treated according to DES guidelines. IU of childhood is a manifestation of underlying DES and should be treated as such. References 1 : Idiopathic anterior urethritis in prepubertal and pubertal boys: pathology and clues to etiology. Urology1998; 51: 99. Google Scholar 2 : Etiology of idiopathic anterior urethritis. Urology1999; 53: 658. Google Scholar 3 : Idiopathic urethritis in the adolescent male. Eur Urol1996; 30: 494. Google Scholar 4 : Clinical comparison of patients with ankylosing spondylitis, Reiter’s syndrome and psoriatic arthritis. J Med Assoc Thai1993; 76: 61. Google Scholar 5 : Idiopathic urethritis in male children. Br J Urol1987; 59: 258. Google Scholar 6 : Idiopathic urethrorrhagia in boys. J Urol1982; 128: 1001. Link, Google Scholar 7 : Musculoskeletal manifestations of human immunodeficiency virus infection. J Am Acad Orthop Surg2002; 10: 312. 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Link, Google Scholar Division of Pediatric Urology, Department of Urology, New York Medical College, New York, New York© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByFranco I (2018) Overactive Bladder in Children. Part 2: ManagementJournal of Urology, VOL. 178, NO. 3, (769-774), Online publication date: 1-Sep-2007. Volume 173Issue 6June 2005Page: 2132-2137 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsurethritisurethral diseasesurination disordershematuriaMetricsAuthor Information DANIEL HERZ More articles by this author ADAM WEISER More articles by this author THERESE COLLETTE More articles by this author EDWARD REDA More articles by this author SELWYN LEVITT More articles by this author ISRAEL FRANCO More articles by this author Expand All Advertisement PDF DownloadLoading ...