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The management of childhood voiding dysfunction
Pramod P Reddy1, John F Redman
1Division of Pediatric Urology, Cincinnati Childern's Hospital Medical Center, Department of Urology, University of Cincinnati, USA.
Insights
Persistent wetting disorders in children, often termed voiding dysfunction, require medical evaluation when they don't resolve naturally. This review focuses on managing these common pediatric urinary incontinence issues.
Area of Science:
- Pediatric Urology
- Child Health
- Urological Disorders
Background:
- Wetting disorders, including urinary incontinence, are common in children.
- While many cases resolve with age, persistent symptoms necessitate medical attention.
- Disorders are broadly categorized into neurogenic bladder and voiding dysfunction.
Purpose of the Study:
- To outline the features, evaluation, and management strategies for pediatric voiding dysfunction.
- To differentiate voiding dysfunction from neurogenic bladder in children.
- To provide a clinical overview for healthcare providers managing childhood wetting problems.
Main Methods:
- Review of existing literature on pediatric voiding dysfunction.
- Clinical guidelines and diagnostic approaches for urinary incontinence in children.
- Management strategies for non-neurogenic bladder issues.
Main Results:
- Voiding dysfunction is characterized by normal neurological function but abnormal bladder emptying.
- Evaluation involves a thorough history, physical examination, and potentially urodynamic studies.
- Management options include behavioral therapy, pharmacotherapy, and biofeedback.
Conclusions:
- Voiding dysfunction is a distinct entity within pediatric wetting disorders.
- A systematic approach to evaluation is crucial for effective management.
- Timely intervention can significantly improve outcomes for children with persistent wetting.
Abstract:
Wetting disorders in children can be frustrating for the patient, his parents and the physician caring for him. Although in most children the urinary incontinence will resolve with maturation, it is the persistent wetter that is brought in for management. There are two main categories of wetting disorders: those associated with neurological dysfunction of the lower urinary tract (neurogenic bladder) and those with normal neurological function (voiding dysfunction). This communication will be limited to the features, evaluation and management of voiding dysfunction.