Etiology and clinical features of bladder dysfunction in children
- Kenneth G Nepple, MD, FACS
Kenneth G Nepple, MD, FACS
- Associate Professor of Urology
- University of Iowa College of Medicine
- Christopher S Cooper, MD, FACS, FAAP
Christopher S Cooper, MD, FACS, FAAP
- Professor of Urology
- University of Iowa College of Medicine
- Section Editors
- Laurence S Baskin, MD, FAAP
Laurence S Baskin, MD, FAAP
- Section Editor — Pediatric Urology
- Frank Hinman, Jr, MD, Distinguished Professorship in Pediatric Urology
- Chief Pediatric Urology
- Professor of Urology and Pediatrics
- UCSF Benioff Children's Hospital
- Tej K Mattoo, MD, DCH, FRCP
Tej K Mattoo, MD, DCH, FRCP
- Section Editor — Pediatric Nephrology
- Professor of Pediatrics
- Wayne State University School of Medicine
Bladder dysfunction, also referred to as voiding dysfunction, is a general term to describe abnormalities in either the filling and/or emptying of the bladder. It is a common problem in children and constitutes up to 40 percent of pediatric urology clinic visits . In some children, bladder dysfunction is a component of bowel and bladder dysfunction (BBD), previously referred to as dysfunctional elimination, which involves abnormalities in both bladder and bowel emptying .
The etiology and clinical features of non-neurologic bladder dysfunction in children will be reviewed here. The evaluation of non-neurologic bladder dysfunction in children is discussed separately. The clinical features, evaluation, and management of children with bladder dysfunction due to myelomeningocele also are discussed separately. (See "Evaluation and diagnosis of bladder dysfunction in children" and "Management of bladder dysfunction in children" and "Urinary tract complications of myelomeningocele (spina bifida)".)
DEFINITIONS OF SYMPTOMS
We use the International Children's Continence Society (ICCS), a global multidisciplinary organization of clinicians involved in the care of children with lower urinary tract dysfunction, standardized definitions for bladder dysfunction symptoms [2,3]. The ICCS definitions apply only to children who are five or more years of age, unless specifically noted otherwise.
●Daytime frequency – Increased daytime frequency is defined as voiding eight or more times during waking hours, whereas decreased daytime frequency is defined as three or fewer voids. The term pollakiuria is also used to define abnormally frequent small voids in a previously toilet-trained child with no evidence of polyuria or urinary tract infection.
●Incontinence – Incontinence is defined as uncontrolled leakage of urine, which can be continuous or intermittent.
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- DEFINITIONS OF SYMPTOMS
- NORMAL VOIDING
- Normal development of bladder control
- Bladder capacity
- Bladder control and urinary continence
- DEFINITION OF BLADDER DYSFUNCTION DISORDERS
- DAYTIME URINARY INCONTINENCE
- Overactive bladder
- Voiding postponement and underactive bladder
- Dysfunctional voiding
- Other conditions
- - Giggle incontinence
- - Vaginal voiding
- - Primary neck bladder dysfunction
- ASSOCIATED CONDITIONS
- Urinary tract infection
- Vesicoureteral reflux
- Bowel and bladder dysfunction
- - Association with UTI and VUR
- Behavioral and neurodevelopmental issues
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS