Zhang Gaofeng,Wang Yuxiang,Li Zhijuan,et al.Establishment of diagnostic system and treatment outcome for urethrovaginal reflux in girls[J].Journal of Clinical Pediatric Surgery,,():872-876.[doi:10.3760/cma.j.cn101785-20260325-00133]
Establishment of diagnostic system and treatment outcome for urethrovaginal reflux in girls
- Keywords:
- Urinary Incontinence; Children; Urethrovaginal Reflux; Bladder Diary
- Abstract:
- Objective To explore the clinical features of urethrovaginal reflux (UVR) in girls and improve pediatricians’ recognition of this disease.Methods Retrospective review was performed for the relevant clinical data of 4 UVR girls from January 2021 to January 2026.And the public databases of PubMed,Wanfang Database,CNKI and VIP were searched for literature items on UVR in girls published up to March 2026.Clinical presentations,diagnostic approaches,treatment strategies and prognostic outcomes were examined.Results Our literature review identified 17 case reports involving 52 UVR girls.Four cases were selected from our hospital.A total of 56 girls had an age range of 3 to 16 years.There was urinary incontinence (n=49) with concurrent urinary tract infection (UTI,n=12).The remainders presented primarily with UTI (n=2),pelvic or low back pain (n=2),vaginitis (n=1),dysuria with vaginitis (n=1) or precocious puberty (n=1).A definite diagnosis was made by voiding diaries combine with urinary tract color Doppler ultrasound (n=26),cystourethrography (n=27) and intravenous pyelography with enhanced urinary tract computed tomography (CT) or magnetic resonance imaging (MRI)(n=3).In our cohort,3 prepubertal girls presented chiefly with urinary incontinence with such comorbidities as obesity (n=3),constipation (n=3),UTI (n=2),overactive bladder (n=2) and nocturnal enuresis (n=1).Voiding diaries consistently demonstrated urine leakage within 10 min after spontaneous voiding.Cystography indicated that vaginal fluid accumulation during voiding resolved upon secondary voiding.Treatment consisted of UVR-specific voiding training combine with urological interventions (n=24).Another 32 cases received additional therapies such as anticholinergics,weight management and constipation relief.Treatment was ineffective in 2 cases with both overactive bladder and elevated residual urine volume.One child relapsed due to poor compliance after initial remission.The remainders responded effectively to treatment.Conclusions UVR predominantly affects prepubertal girls.Characteristic voiding diary findings include urine leakage within 10 min after spontaneous voiding with minimal or no leakage in intervals preceding the next void.Cystography typically reveals vaginal fluid accumulation during voiding and clearing after a secondary void.Girls around puberty exhibiting hallmark voiding diary and cystographic features are definitely diagnosed as UVR.The cornerstone of management involves UVR-specific voiding posture training and urological therapy.The clinical outcomes are strongly influenced by patient adherence and a proper management of comorbid conditions,generally resulting in favorable results.For those with inadequate response,further assessments of urodynamic studies are advised to tailor individualized treatment protocols.
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Memo
收稿日期:2026-3-25。
基金项目:西安市科学技术局项目（24YXYJ0059）
通讯作者:白明,Email:573076087@qq.com