Related Experiment Video
Updated: May 18, 2026
Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
[Voiding disorders in childhood: from symptoms to diagnosis]
J Bréaud1, I Oborocianu, F Bastiani
1Unité de chirurgie pédiatrique viscérale, hôpitaux pédiatriques de Nice, GCS CHU Lenval, 57, avenue de la Californie, 06200 Nice, France.
Insights
New definitions for childhood voiding disorders aid clinical practice. Key types include isolated primary nocturnal enuresis and urinary dysfunctions, with constipation often an overlooked cause.
Area of Science:
- Pediatric Urology
- Child Health
- Clinical Definitions
Context:
- Current clinical practice lacks standardized definitions for pediatric voiding disorders.
- Underdiagnosis of underlying causes like constipation is common.
- Accurate diagnosis is crucial for effective treatment.
Purpose:
- To introduce and advocate for new definitions of pediatric voiding disorders.
- To guide clinicians in differentiating between primary enuresis and urinary dysfunctions.
- To emphasize the importance of a thorough diagnostic process.
Summary:
- Two main categories of pediatric voiding disorders are defined: isolated primary nocturnal enuresis (sleep-only wetting) and urinary dysfunctions (detrusor overactivity, sphincter hypertonicity, urethral instability).
- These conditions can be primary or secondary, with constipation frequently an underestimated contributing factor.
- Diagnosis involves detailed history, physical examination, and potentially urodynamics, focusing on differentiating sleep-specific from daytime/sleep symptoms after excluding secondary causes.
Impact:
- Facilitates accurate diagnosis and targeted therapy for children with voiding disorders.
- Promotes a systematic approach to evaluating pediatric lower urinary tract symptoms.
- Improves clinical management by highlighting common, often missed, etiologies such as constipation.
Abstract:
The new definitions of voiding disorders in children should be used in clinical practice. Two major kinds of voiding disorders are identified: 1) isolated primary enuresis as a disorder occurring exclusively during sleep with no daytime leakage; 2) urinary dysfunctions that include uninhibited detrusor contraction, sphincter hypertonicity, and urethral instability. These dysfunctions may be primary or secondary. Constipation as an underlying cause is frequent and usually underestimated. The diagnostic process requires one (or more) long consultations. After ruling out a urine leak without a voiding disorder and secondary causes (constipation, inadequate hydration, poor voiding hygiene, crystalluria, etc.), the aim is to distinguish isolated sleep-time disorders (primary enuresis) from daytime ± sleep-time symptoms (primary urinary dysfunctions). Anamnesis, long and accurate, can be sensitized by a questionnaire completed at home. The physical examination focuses on the exclusion of anatomic abnormalities and local inflammation (vulvitis, balanitis, etc.). Diagnostic tests are rarely required at the beginning. Urodynamic exploration may be indicated, never at the first consultation, in case of primary urinary dysfunction. This diagnostic approach provides an appropriate therapeutic decision.
Related Concept Videos
01:30Oppositional Defiant Disorder
Diagnostic Criteria and...
01:20Disorders of the Urinary System
Urinary tract infections (UTIs) are one of the most common urinary system disorders. They are caused by bacteria that enter the urethra and can spread to the bladder resulting in cystitis. Pyelonephritis is the result of a UTI that has ascended to the level of the...
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
01:25Formulating and Validating Nursing Diagnosis II
Risk nursing diagnoses represent clinical judgments of an individual, family, or community more vulnerable to developing the health problem than others...
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.
01:28Conduct Disorder