Treatment modalities for paediatric functional daytime lower urinary tract disorders: an updated review

Area of Science:

• Pediatric Urology
• Pediatric Nephrology

Background:

• Functional bladder disorders in children, particularly daytime symptoms, cause significant psychosocial morbidity and reduced quality of life.
• Many children remain refractory to existing treatments, necessitating further research into effective management strategies.

Purpose of the Study:

• To review current evidence on existing and novel therapeutic options for daytime lower urinary tract disorders in children.
• To address controversies in terminology and diagnosis of pediatric lower urinary tract dysfunction (LUTD).
• To critique emerging and established treatment modalities for functional daytime LUTD.

Main Methods:

• Comprehensive literature review of existing and emerging treatments for pediatric functional daytime lower urinary tract disorders.
• Analysis of urotherapy (standard and specific), pharmacotherapy, and other interventions.
• Evaluation of treatment efficacy, mode of action, and indications.

Main Results:

• Urotherapy (standard and specific, including biofeedback, alarm therapy, electrical neural stimulation) and pharmacotherapy (anticholinergics, ß3 adrenergic agonists, alpha blockers, botulinum toxin) are key treatment modalities.
• Evidence for efficacy and optimal use of these treatments varies, with ongoing research into novel approaches.
• Challenges remain in diagnosis and achieving targeted treatment for refractory cases.

Conclusions:

• A better understanding of pediatric functional daytime LUTD is crucial for improved diagnosis and targeted treatment.
• Further research is needed to optimize management strategies for children with refractory symptoms.
• Standardized terminology and diagnostic criteria are essential for effective clinical practice and research.