Voiding Dysfunction in Pediatric Patients

Abstract

The goals of this study were to describe the pattern of voiding disorders in children in our community, to describe clinical criteria for making the specific diagnoses, and to comment on management. The medical records of 226 children referred because of voiding dysfunction or urinary tract infections (UTI) were evaluated. Children with normal voiding patterns when uninfected, with monosymptomatic nocturnal enuresis, and with known neurologic or anatomic abnormalities were excluded. Detrusor instability, an abnormal voiding pattern characterized by urgency with or without frequency, was the diagnosis in 175 of the 226 children. Children with detrusor instability who used various posturing maneuvers to avoid urinary incontinence had a significantly higher incidence of UTIs than those who did not attempt to obstruct urine outflow. Detrusor instability appeared to be secondary to constipation in 19 of the children. The other diagnoses were extraordinary daytime urinary frequency, infrequent voiding, monosymptomatic daytime wetting, transient voiding dysfunction, giggle incontinence, dysfunctional voiding, and unexplained dysuria. It is concluded that children with detrusor instability who use posturing maneuvers to avoid incontinence are at high risk for recurrent UTIs. Constipation is 1 cause of detrusor instability. Dysfunctional voiding, the form of voiding dysfunction most likely to result in renal damage, was present in only 2 of 226 children seen for voiding disorders.

Investigação de disfunção miccional em uma amostra populacional de crianças de 3 a 9 anos

“…When urinary urgency is not followed by holding maneuvers, there is no risk of UTI, but there is a possibility of diurnal urinary incontinence. 13 Voiding dysfunction is a wide term that indicates an abnormal urinary pattern for the age of the child, 14 which is not usually recognized before daytime bladder control, has been achieved. 7 The literature shows an increase in prevalence rates for voiding dysfunction over recent years.…”

“…7 The literature shows an increase in prevalence rates for voiding dysfunction over recent years. [14][15][16] However, Bakker 16 questions whether this increase is real, or whether it could be the result of parents increased knowledge of the existence of treatment for the problem. In the present study it was observed that the great majority of parents did not recognize the symptoms and explained holding maneuvers and urgency as laziness or leaving it till the last minute because playing.…”

The standardization of terminology of lower urinary tract function in children and adolescents: Report from the standardization committee of the International Children's Continence Society (ICCS)

“…The term cannot be applied unless repeated uro£ow measurements have shown curves with a staccato patternöor if veri¢ed by invasive urodynamic investigation. Note that the term describes malfunction during the voiding phase only, it says nothing about the storage phase.The usage of this expression to denote any kind of disturbed LUT function [Hellerstein and Linebarger, 2003], leads to confusion and is strongly discouraged. Dysfunctional voiding means dysfunction during voiding.…”

Comparison of Development Indicators, According to Ages and Stages Questionnaires in Children with Pollakiuria Compared to Healthy Children

“…This condition, as a common problem in children, makes up more than 40% of pediatric urology clinic visits (4,5). Children with Pollakiuria show extraordinary daytime urinary frequency, urination every 15 to 20 minutes per day without nocturnal enuresis, urinary incontinence, dysuria, and urinary tract infections (UTIs) (6).…”