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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
Review

Abstract

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.

Keywords

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

Abbreviations

DSM-5

Diagnostic and statistical manual (5th edition)

DUD

Detrusor underutilization disorder

DUI

Daytime urinary incontinence

DV

Dysfunctional voiding

FI

Fecal incontinence

ICCS

International Children’s Continence Society

ICD-10

International classification of diseases

LUTS

Lower urinary tract symptoms

LUTD

Lower urinary tract dysfunction

NE

Nocturnal enuresis

OAB

Overactive bladder

ODD

Oppositional defiant disorder

UB

Underactive bladder

UUI

Urge urinary incontinence

VP

Voiding postponement

VPI

Voiding postponement incontinence

Notes

Compliance with ethical standards

Conflict of interests

None.

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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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