Dysfunctional voiding and urodynamic disorders in children with recurrent urinary tract infection

The purpose of the study was to determine: a) the incidence of particular symptoms of dysfunctional voiding, b) the incidence of particular urodynamic disorders, and c) urodynamic patterns typical of particular symptoms of dysfunctional voiding in children with recurrent urinary tract infection. The study comprised 282 children with recurrent urinary tract infection. In order to diagnose functional disturbances of the lower urinary tract, such as detrusor instability, detrusor-sphincter dyscoordination, detrusor instability associated with detrusor-sphincter dyscoordination, and functional subvesical obstruction, in all children, urodynamic examination was performed. For each symptom of dysfunctional voiding (nocturnal enuresis, diurnal urinary incontinence, urinary urgency, and voiding postponement syndrome) urodynamic pattern was determined. The study revealed that functional disturbances of the lower urinary tract coexist with positive histories of micturition disturbances. In the studied children, detrusor instability was the most common urodynamic disorder. Nocturnal enuresis, diurnal urinary incontinence and urinary urgency were symptoms of dysfunctional voiding typical of detrusor stability. In children with and without vesico-ureteral reflux, the incidences of particular urodynamic disorders were similar. This seems to suggest that disturbances of the lower urinary tract may be secondary to infection.