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Archives de pédiatrie
Volume 19, n° 11
pages 1226-1230 (novembre 2012)
Doi : 10.1016/j.arcped.2012.08.003
Received : 9 February 2012 ;  accepted : 7 August 2012
Troubles mictionnels de l’enfant : de la physiologie à la symptomatologie clinique
Voiding disorders in childhood: From physiology to symptomatology

J. Bréaud a, I. Oborocianu a, F. Bastiani a, A. Bouty a, E. Bérard b,
a Unité de chirurgie pédiatrique viscérale, hôpitaux pédiatriques de Nice, GCS CHU-Lenval, 57, avenue de la Californie, 06200 Nice, France 
b Unité de néphrologie pédiatrique, hôpitaux pédiatriques de Nice, GCS CHU-Lenval, 57, avenue de la Californie, 06200 Nice, France 

Auteur correspondant.

La miction, évènement pluriquotidien et naturel, résulte d’une physiologie complexe et incomplètement connue. Elle fait intervenir différents muscles (striés et lisses), commandés par les systèmes nerveux volontaire et involontaire, dans un réflexe mictionnel inné qui peut être contrôlé à partir de l’âge de 2ans. Une dysfonction de l’un ou plusieurs de ce complexe musculo-nerveux engendre des troubles mictionnels soit par anomalie neuromusculaire de l’automatisme vésical, soit par défaut de contrôle cérébral. Enfin, le réflexe mictionnel subit les interférences d’autres facteurs multiples comme la constipation, l’irritation vésicale ou l’hyperpression abdominale. Les nouvelles définitions et classifications internationales des troubles mictionnels permettent une approche plus aisée par un interrogatoire orienté et complet et un examen clinique simple, qui dans beaucoup de cas, permet d’attribuer le trouble mictionnel à l’une ou l’autre de ces causes et de proposer une prise en charge spécifique.

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Micturition is a natural event occurring several times a day, the result of a complex and partially unknown physiology. It involves different muscles (striated and smooth) as well as the central and autonomic nervous systems in an innate voiding reflex. This reflex is controlled after 2 years of age. If there is a failure or dysfunction of one of these elements, a miction disorder may appear. Two types of miction disorders are identified: neuromuscular disorders of the bladder and defective central control. Multiple factors such as constipation, bladder irritation, or an increase in abdominal pressure can interfere with the voiding reflex. The new international definitions and classifications of voiding disorders allow an easier clinical approach through careful and complete questioning and a simple clinical exam, efficient enough in most cases to provide the diagnosis and adapted treatment.

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© 2012  Published by Elsevier Masson SAS.
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