Diagnosis and management of dysfunctional voiding

Area of Science:

• Pediatric Urology
• Childhood Developmental Disorders

Background:

• Voiding dysfunction in children, recently classified as dysfunctional elimination syndromes, often emerges post-toilet training.
• These conditions can stem from behavioral issues during critical developmental stages.

Purpose of the Study:

• To review the diagnosis and management of voiding dysfunction in neurologically and anatomically normal children.
• To highlight recent advancements in clinical approaches, etiology, and classification of these disorders.

Main Methods:

• Comprehensive review of established diagnostic and treatment modalities.
• Emphasis on clinical history, physical examination, radiologic, and urodynamic evaluations.

Main Results:

• The spectrum includes urge syndrome, dysfunctional voiding (detrusor-sphincter dyssynergia), and enuresis.
• Symptoms range from mild incontinence to severe outcomes like vesicoureteral reflux and nephropathy.
• Treatment typically involves anticholinergic medications and behavioral modification therapies.

Conclusions:

• Established diagnostic and treatment strategies for pediatric voiding dysfunction are outlined.
• Recent developments in the field are emphasized, providing an updated overview.