Disfungsi Kandung Kemih Non-Neurogenik pada Anak: Diagnosis dan Tata Laksana - Sudung O. Pardede; William J. Iskandar; Bernadetha Nadeak (Fakultas Kedokteran Universitas Kristen Indonesia, 2018)
AbstrakDisfungsi kandung kemih (lower urinary tract dysfunction) merupakan masalah berkemih yang sering ditemukanpada anak, dapat berupa disfungsi neurogenik, anatomis, maupun non-neurogenik. Masalah tersebut sering disertaiinfeksi saluran kemih, refluks vesikoureter, dan parut ginjal yang berpotensi menyebabkan penyakit ginjal kronik,serta memiliki dampak fisik dan psikososial yang berat pada anak. Manifestasi klinis disfungsi kandung kemihmuncul sesuai dengan patofisiologi berkemih, yakni gangguan pada pengisian (storage) atau gangguan miksi(voiding), dengan deskripsi istilah atau terminologi mengacu pada konsensus International Children’s ContinenceSociety (ICCS) 2015. Diagnosis ditegakkan secara klinis melalui anamnesis dan pemeriksaan fisik dengan prinsiputama menyingkirkan kelainan neurologis dan anatomis, serta pencatatan urin rutin. Modalitas pemeriksaanpenunjang dapat bersifat noninvasif (urinalisis, ultrasonografi, uroflowmetry) maupun invasif (sistogram). Tatalaksana komprehensif disfungsi kandung kemih non-neurogenik terdiri atas uroterapi (termasuk terapi biofeedback),terapi farmakologis, terapi bedah, dan neuromodulasi atau neurostimulasi. Kata Kunci: disfungsi kandung kemih, non neurogenik, uroterapiAbstractBladder dysfunction or lower urinary tract dysfunction is frequently found in children, which can be caused byneurologic, anatomical, or functional (non-neurogenic) problem. Urinary tract infection, vesicoureteral reflux, andrenal scar are common secondary to bladder dysfunction, leading to chronic kidney disease and causing seriousphysical and psychosocial impact in childlhood. Clinical manifestation correlates well with the pathophysiology,either storage (filling) or voiding problem. Standard terms have been published by International Children’sContinence Society (ICCS) 2015. Diagnosis of bladder dysfunction could be clinically established by history takingand physical examination, focusing on excluding neurological or anatomical lesion and voiding diary. Furtherexamination consists of non-invasive methods (urinalysis, ultrasonography, and uroflowmetry) or invasive methods(cystogram). Comprehensive management includes urotherapy (including biofeedback therapy), pharmacologicaltreatment, urosurgery, and neuromodulation or neurostimulation. Keywords: : bladder dysfunction, non neurogenic, urotherapy