[Congenital and acquired bladder-sphincter dysfunction]

The unstable bladder, or bladder-sphincter dysfunction, is the result of unbalanced maturation and physiological control of bladder function in the young child. It is characterised by the persistence of the reflex-bladder stage typical in the newborn, and in the older child can be seen as either a bladder-filling problem or as an emptying problem. It can be responsible for enuresis, urinary tract infections and squatting, as well as the more serious morphological charges of the upper urinary tract such as reflux uropathy and pyelonephritis. This article aims to present the aetiopathology to describe the clinical characteristics of the syndrome and suggest a diagnostic and therapeutic approach to the problem.