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Updated: Aug 16, 2026
Real-Time Void Spot Assay
Published on: February 10, 2023
[Functional disorders of the lower urinary tract in children]
1Klinische Abteilung für Kinderradiologie, Radiologische Univ.-Klinik Graz. richard.fotter@meduni-graz.at
Insights
Functional lower urinary tract disorders, including unstable bladder and dysfunctional voiding, are significant risk factors for urinary tract infections and kidney damage in children. These conditions impede the resolution of vesicoureteral reflux and increase the likelihood of renal scarring.
Area of Science:
- Pediatric Urology
- Nephrology
- Pediatric Gastroenterology
Background:
- Functional lower urinary tract disorders are risk factors for urinary tract infections (UTIs) and renal parenchymal damage.
- These disorders include unstable bladder and dysfunctional voiding, often co-occurring with vesicoureteral reflux (VUR).
- VUR is a condition where urine flows backward from the bladder to the kidneys, increasing infection risk.
Purpose of the Study:
- To investigate the role of functional lower urinary tract disorders in pediatric UTIs and renal damage.
- To highlight the association between these disorders, VUR, and the development of renal scars.
- To emphasize the importance of early diagnosis and preferred noninvasive imaging methods.
Main Methods:
- Review of clinical data and diagnostic procedures for children with UTIs and suspected lower urinary tract dysfunction.
- Correlation analysis between voiding disorders, VUR, and renal parenchymal damage.
- Emphasis on urodynamic and imaging techniques, including sonography.
Main Results:
- Functional lower urinary tract disorders are present in approximately 50% of children with UTIs.
- These disorders obstruct VUR resolution and are linked to a higher risk of renal scarring.
- Incontinence, a key symptom, is strongly correlated with chronic constipation, affecting about 70% of cases.
Conclusions:
- Functional lower urinary tract disorders are critical predisposing factors for recurrent UTIs and renal damage in children.
- Early identification and management of voiding dysfunction are crucial to prevent long-term renal sequelae.
- Noninvasive imaging like sonography, alongside urodynamics, is recommended for diagnosis and treatment planning.
Abstract:
Functional disorders of the lower urinary tract as well as vesicoureteral reflux involved in the disease complex of urinary tract infection/permanent renal parenchymal damage can be considered predisposing or risk factors. Two main forms can be distinguished, i.e., unstable bladder and dysfunctional voiding, while transitional forms between the two exist. Functional disorders of the lower urinary tract obstruct spontaneous resolution of vesicoureteral reflux. They are found in about 50% of cases in all children with urinary tract infection and are associated with an increased risk of developing renal parenchymal scars. They are observed during the newborn period up to school age. In the first few months of life, particularly boys with bilateral high-grade reflux and congenital renal parenchymal damage are affected. At later ages girls are also affected, but in this age group bladder instability predominates. Incontinence as the leading clinical symptom appears in approximately 70% of all cases and is closely correlated with chronic constipation. Imaging procedures in addition to urodynamic methods are of decisive importance for diagnosis and treatment, but noninvasive approaches such as sonography should be given preference.
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