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Voiding postponement in children-a systematic review.

Alexander von Gontard1, Justine Niemczyk2, Catharina Wagner2

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Summary
This summary is machine-generated.

Voiding postponement (VP) is delaying urination, which can be a symptom or a condition like voiding postponement incontinence (VPI). VPI often co-occurs with behavioral issues and requires urotherapy, timed voiding, and sometimes cognitive behavioral therapy.

Keywords:
Daytime urinary incontinenceNon-monosymptomatic nocturnal enuresisOppositional defiant disorderVoiding postponement

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Area of Science:

  • Urology
  • Pediatrics
  • Behavioral Science

Background:

  • Voiding postponement (VP) is defined as habitually delaying urination using holding maneuvers.
  • VP can manifest as a symptom in healthy children or a condition, particularly voiding postponement incontinence (VPI).
  • International definitions vary, necessitating a review for standardized assessment, diagnosis, and treatment.

Purpose of the Study:

  • To review the current knowledge on voiding postponement (VP).
  • To provide recommendations for the assessment, diagnosis, and treatment of VP and VPI.
  • To differentiate VP as a symptom from VPI as a condition.

Main Methods:

  • Conducted a comprehensive literature search using Scopus and PubMed with the term 'voiding postponement'.
  • Included other relevant publications to supplement the search findings.
  • Synthesized information to establish current understanding and propose guidelines.

Main Results:

  • VP can be a symptom in children or a condition, often termed voiding postponement incontinence (VPI) when associated with daytime urinary incontinence.
  • VPI is characterized by habitual deferral of micturition, low voiding frequency, urgency, and behavioral problems.
  • Oppositional defiant disorder (ODD) is the most common comorbid disorder with VPI.

Conclusions:

  • Differentiating VP as a symptom from VPI as a condition is crucial.
  • VPI is a prevalent disorder with significant associated problems and comorbidities.
  • Primary treatments include urotherapy and timed voiding, with cognitive behavioral therapy often necessary due to high rates of comorbid ODD.