European Child & Adolescent Psychiatry

, Volume 25, Issue 8, pp 809–820 | Cite as

Voiding postponement in children—a systematic review

  • Alexander von GontardEmail author
  • Justine Niemczyk
  • Catharina Wagner
  • Monika Equit


Voiding postponement (VP) has been defined as a habitual postponement of micturition using holding maneuvers. VP can represent both a symptom, as well as a condition. As divergent definitions are used internationally, the aim was to review the current state of knowledge on VP and provide recommendations for assessment, diagnosis and treatment. A Scopus and a Pubmed search was conducted, entering the terms ‘voiding postponement’ without any restrictions or specifications. Other publications relevant to the topic were added. VP can represent a symptom in healthy children. As a condition, VP in combination with nocturnal enuresis (NE) is a subtype of non-monosymptomatic NE. Most studies have focused on daytime urinary incontinence (DUI) with VP, or more aptly termed voiding postponement incontinence (VPI). It is a behaviorally defined syndrome, i.e., by the habitual deferral of micturition and DUI. VPI is associated with a low micturition frequency, urgency and behavioral problems. The most common comorbid disorder is oppositional defiant disorder (ODD). VP as a symptom and VPI as a condition should be differentiated. VPI is a common disorder with many associated problems and disorders. Urotherapy and timed voiding are the main treatment approaches. Due to the high rate of comorbid ODD, other forms of treatment, especially cognitive behavioral therapy, are often needed.


Voiding postponement Daytime urinary incontinence Non-monosymptomatic nocturnal enuresis Oppositional defiant disorder 



Diagnostic and statistical manual (5th edition)


Detrusor underutilization disorder


Daytime urinary incontinence


Dysfunctional voiding


Fecal incontinence


International Children’s Continence Society


International classification of diseases


Lower urinary tract symptoms


Lower urinary tract dysfunction


Nocturnal enuresis


Overactive bladder


Oppositional defiant disorder


Underactive bladder


Urge urinary incontinence


Voiding postponement


Voiding postponement incontinence


Compliance with ethical standards

Conflict of interests



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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Alexander von Gontard
    • 1
    Email author
  • Justine Niemczyk
    • 1
  • Catharina Wagner
    • 1
  • Monika Equit
    • 2
  1. 1.Department of Child and Adolescent PsychiatrySaarland University HospitalHomburgGermany
  2. 2.Department of Clinical PsychologySaarland UniversitySaarbrückenGermany

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