Disfungsi Kandung Kemih Non-Neurogenik pada Anak: Diagnosis dan Tata Laksana

Abstract

Abstrak
Disfungsi kandung kemih (lower urinary tract dysfunction) merupakan masalah berkemih yang sering ditemukan
pada anak, dapat berupa disfungsi neurogenik, anatomis, maupun non-neurogenik. Masalah tersebut sering disertai
infeksi 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 kemih
muncul sesuai dengan patofisiologi berkemih, yakni gangguan pada pengisian (storage) atau gangguan miksi
(voiding), dengan deskripsi istilah atau terminologi mengacu pada konsensus International Children’s Continence
Society (ICCS) 2015. Diagnosis ditegakkan secara klinis melalui anamnesis dan pemeriksaan fisik dengan prinsip
utama menyingkirkan kelainan neurologis dan anatomis, serta pencatatan urin rutin. Modalitas pemeriksaan
penunjang dapat bersifat noninvasif (urinalisis, ultrasonografi, uroflowmetry) maupun invasif (sistogram). Tata
laksana 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, uroterapi

Abstract
Bladder dysfunction or lower urinary tract dysfunction is frequently found in children, which can be caused by
neurologic, anatomical, or functional (non-neurogenic) problem. Urinary tract infection, vesicoureteral reflux, and
renal scar are common secondary to bladder dysfunction, leading to chronic kidney disease and causing serious
physical 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’s
Continence Society (ICCS) 2015. Diagnosis of bladder dysfunction could be clinically established by history taking
and physical examination, focusing on excluding neurological or anatomical lesion and voiding diary. Further
examination consists of non-invasive methods (urinalysis, ultrasonography, and uroflowmetry) or invasive methods
(cystogram). Comprehensive management includes urotherapy (including biofeedback therapy), pharmacological
treatment, urosurgery, and neuromodulation or neurostimulation.

Keywords: : bladder dysfunction, non neurogenic, urotherapy