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Management of daytime urinary incontinence and lower urinary tract symptoms in children
Aniruddh V Deshpande1, Jonathan C Craig, Grahame H H Smith
1Department of Urology, Children's Hospital at Westmead, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. sushrudh@hotmail.com
Insights
Daytime urinary incontinence and lower urinary tract symptoms in children are common but often overlooked. This paper offers an evidence-based approach for pediatricians to manage these conditions, focusing on non-neurogenic voiding disorders.
Area of Science:
- Pediatrics
- Urology
- Child Health
Background:
- Lower urinary tract symptoms (LUTS), including urgency, frequency, and incontinence, are prevalent in school-aged children.
- These symptoms can significantly impact a child's physical, social, and psychological well-being and are often linked to non-neurogenic voiding disorders.
Purpose of the Study:
- To provide a general pediatrician's perspective on an evidence-based approach to managing daytime urinary incontinence and LUTS in children.
- To outline differential diagnoses for these common pediatric conditions.
Main Methods:
- Review of current literature and clinical guidelines for pediatric lower urinary tract symptoms.
- Discussion of diagnostic criteria and management strategies for common and less common causes of daytime urinary incontinence in children.
Main Results:
- Identified overactive bladder syndrome, dysfunctional voiding, and vaginal reflux as key differential diagnoses.
- Highlighted less common conditions such as giggle incontinence, voiding postponement, pollakiuria, and diabetes insipidus.
Conclusions:
- Emphasizes the importance of recognizing and addressing LUTS in children.
- Advocates for an evidence-based, systematic approach to diagnosis and management by general pediatricians.
Abstract:
Lower urinary tract symptoms, particularly urgency, frequency and incontinence are common in school-aged children but are often overlooked. They may cause considerable physical, social and psychological difficulties to children and their families, and usually are manifestations of underlying non-neurogenic voiding disorders. The differential diagnoses include overactive bladder syndrome, dysfunctional voiding and vaginal reflux as well as less common conditions like giggle incontinence, voiding postponement, pollakiuria and diabetes insipidus. In this paper, we discuss an evidence-based approach to the management of conditions causing daytime urinary incontinence and lower urinary tract symptoms in children from a general paediatrician's perspective.
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