Voiding disorders in children

Abstract

Voiding disorders are frequently encountered in children. Most of them present without neurological or structural lesions of the urinary tract. Such children have what is known as dysfunctional voiding, caused by functional incoordination of the bladder and urethral sphincteric mechanism. The consequences are incontinence, obstruction of the urine flow, and increased intravesical pressure which may damage the upper urinary tract and kidneys. Urodynamic evaluation has greatly contributed to the characterization of these disorders. This paper describes the basic principles of the physiology of continence and micturition in children, and suggest an approach to the child with disorders in voiding, especially regarding urodynamic evaluation. Individual patterns of dysfunctional voiding, its characteristics, clinical significance and treatment are discussed.