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Management of bladder dysfunction in children

Kenneth G Nepple, MD, FACS
Christopher S Cooper, MD, FACS, FAAP
Section Editors
Laurence S Baskin, MD, FAAP
Tej K Mattoo, MD, DCH, FRCP
Deputy Editor
Melanie S Kim, MD


Bladder dysfunction, previously 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 [1]. In some children, bladder dysfunction is a component of bowel and bladder dysfunction, previously referred to as the dysfunctional elimination syndrome, which involves abnormalities in both bladder and bowel function.

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 [4]. Thus, it is desirable to identify and treat these children as early as possible.

The management of bladder dysfunction in children will be reviewed here. The etiology, clinical features, evaluation, and diagnosis of bladder dysfunction and management of nocturnal enuresis in children are discussed separately. (See "Etiology and clinical features of bladder dysfunction in children" and "Evaluation and diagnosis of bladder dysfunction in children" and "Nocturnal enuresis in children: Management".)


The management of a child with bladder dysfunction is primarily directed at improving symptoms and avoiding renal damage. Therapeutic considerations include the underlying cause of bladder dysfunction including behavioral and neurodevelopment etiologies, the age of the patient, symptom duration and severity, the motivation and attention span of the patient and family, and the presence of potential risk factors for renal injury such as recurrent urinary tract infections or vesicoureteral reflux. (See "Etiology and clinical features of bladder dysfunction in children", section on 'Dysfunctional voiding'.)

Data on effective treatment of bladder dysfunction in children are limited because of the following flaws in study design:

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Literature review current through: Nov 2017. | This topic last updated: Sep 12, 2017.
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