Evaluation and Targeted Therapy of Voiding Dysfunction in Children.

Area of Science:

• Pediatric Urology
• Child Health
• Urodynamics

Background:

• Pediatric voiding complaints are common.
• Advances in the last 20 years have improved evaluation and management.
• Accurate diagnosis is crucial for effective treatment.

Purpose of the Study:

• To outline current best practices for evaluating and managing pediatric voiding complaints.
• To emphasize the importance of accurate diagnosis for targeted therapy.

Main Methods:

• Comprehensive patient history.
• Physical examination.
• Urine studies and select imaging.
• Uroflowmetry and external sphincter electromyography.
• Measurement of postvoid residual urine.
• Utilizing International Children's Continence Society (ICCS) diagnostic categories.

Main Results:

• A systematic approach combining history, physical exam, and specific tests enables precise diagnosis.
• Accurate diagnosis allows for classification within established pediatric voiding dysfunction categories.
• Effective management relies on identifying the underlying cause of the voiding complaint.

Conclusions:

• Current diagnostic methods allow for precise evaluation of children with voiding complaints.
• Targeted treatment strategies, including urotherapy, pharmacotherapy, biofeedback, and neuromodulation, are guided by accurate diagnosis.
• Improved diagnostic capabilities lead to more effective management of pediatric voiding dysfunction.