[Bladder immaturity in children: from enuresis to renal insufficiency]

The persistent infantile bladder is a common urological disorder in childhood. This syndrome is usually manifested by bedwetting, diurnal urge incontinence, characteristic holding postures, recurrent lower urinary tract infections and morphological changes of the bladder. The urodynamic evaluation show hyperreflexic bladder with detrusor sphincter dyssynergia. The pathologic mechanism is responsible for perpetuating and possibly initiating many "primary" vesico-ureteral refluxes. In most cases, the spontaneous resolution of detrusor activity by neurological maturation is usual. However, oxybutinin therapy (antimuscarinic drug) achieves pharmacological education of the bladder function and prevents complications due to high intravesical pressure induced by dyssynergia.