[Functional vesico-sphincteric disorders in children: clinical, urodynamic and evolutionary profile]

Area of Science:

• Pediatric Nephrology
• Urology
• Pediatric Gastroenterology

Background:

• Childhood vesico-sphincteric disorders lead to functional and psychological disability.
• These disorders can cause severe uronephrologic complications, similar to neurogenic bladder.
• Understanding clinical, paraclinical, and urodynamic aspects is key for management.

Purpose of the Study:

• To investigate clinical manifestations of childhood vesico-sphincteric disorders.
• To identify associated paraclinical and urodynamic anomalies.
• To evaluate therapeutic management strategies for these conditions.

Main Methods:

• Retrospective and descriptive study design.
• Inclusion of 26 pediatric patients with vesico-sphincteric disorders.
• Data collected from the pediatrics department of Charles Nicolle hospital in Tunis.

Main Results:

• A predominance of girls (43 vs 19 boys) with a median age of 9 years at first consultation.
• Common findings included multiple symptoms during filling/voiding phases, reduced bladder sensation (14%), detrusor overactivity (65%), hypocompliant bladder (42%), and small bladder capacity (88%).
• Significant renal impairment was noted in 45% of patients, with 11% having end-stage renal failure, and 16% requiring kidney replacement therapy during follow-up.

Conclusions:

• Vesico-sphincteric disorders in children are serious and often diagnosed late at the complication stage.
• Targeted primary prevention through continuous training of primary care physicians is essential.
• Minimizing complications is vital for the functional and vital prognosis of affected children.