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Abstract:
After a description of the bladder-sphincter system physiology and of the different stages in the acquisition of micturition control by children, as revealed by urodynamic explorations, the author presents the bladder immaturity syndrome. This entity includes diurnal disorders of micturition--such as urgencies, pollakiuria, more seldom retention and incontinence--which can readily be identified by questioning. It accounts for many cases of nocturnal enuresis which may benefit from treatment with anticholinergic drugs. Nocturnal enuresis without disorders of micturition in daytime is due to other physiopathological mechanisms. It is preferably treated with tricyclic antidepressants and other non-medicinal therapies. All cases should be investigated for a possible organic pathology. A practical classification of enuresis is given.