Evaluation and diagnosis of bladder dysfunction in children
- Kenneth G Nepple, MD
Kenneth G Nepple, MD
- Assistant 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
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, previously referred to as dysfunctional elimination, which involves abnormalities in both bladder and bowel emptying.
Daytime urinary incontinence, a common feature of bladder dysfunction, can cause major stress in school-age children [2,3], and negatively impact a child's self-esteem . Thus, it is desirable to identify and treat affected school-age children as early as possible.
The evaluation of non-neurologic bladder dysfunction in children will be reviewed here. The etiology and clinical features of bladder dysfunction in children are discussed separately. The clinical features, evaluation, and management of children with bladder dysfunction due to myelomeningocele also are discussed separately. (See "Etiology and clinical features of bladder dysfunction in children" and "Management of bladder dysfunction in children" and "Urinary tract complications of myelomeningocele (spina bifida)".)
The goals of the evaluation for suspected bladder dysfunction in children are to:
●Determine whether the child has an abnormality in either filling and/or emptying of the bladder.
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- WHEN TO SUSPECT BLADDER DYSFUNCTION
- INITIAL EVALUATION
- - Voiding diary
- Physical examination
- Laboratory studies
- FURTHER EVALUATION
- - Ultrasonography
- - Voiding cystourethrogram
- - Magnetic resonance imaging
- Urinary flow measurement
- - Shape of urine flow curve
- - Other parameters
- Urodynamic testing
- - Indications
- - Urodynamic patterns
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS