Hinman Syndrome: A Rare Entity With Neurogenic Bladder-Like Symptoms

Area of Science:

• Pediatric Urology
• Behavioral Medicine
• Diagnostic Imaging

Background:

• Hinman syndrome is a rare condition often misdiagnosed, presenting with symptoms like enuresis, urinary retention, and recurrent UTIs.
• Clinical and radiographic findings can mimic neurogenic bladder, complicating diagnosis without thorough history and neurological assessment.

Observation:

• A 14-year-old boy presented with nausea, flank pain, and urinary retention, alongside a seven-year history of recurrent UTIs and encopresis.
• Previous evaluations for neurogenic bladder, including lumbar spine MRI, were normal.
• Fluoroscopic voiding cystourethrogram (VCUG) revealed an abnormal, trabeculated bladder contour with bilateral vesicoureteral reflux.

Findings:

• The VCUG findings were consistent with a diagnosis of Hinman syndrome.
• This contrasts with the normal neurological examination and MRI findings often seen in Hinman syndrome.

Implications:

• This case underscores the diagnostic utility of VCUG in identifying Hinman syndrome when other investigations are inconclusive.
• Accurate diagnosis is crucial as Hinman syndrome is considered an acquired behavioral and psychological disorder.
• Improved diagnostic strategies can lead to timely intervention and management for patients with Hinman syndrome.