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Lower Urinary Tract Dysfunction in Children and Young Adults: An Introduction

  • Tryggve Nevéus
Chapter
Part of the Urodynamics, Neurourology and Pelvic Floor Dysfunctions book series (UNPFD)

Abstract

Disorders of the paediatric lower urinary tract can conveniently be classified into disturbances of the storage or voiding phase. Among disorders of urine storage, daytime urge incontinence and nocturnal enuresis are by far the most prevalent. The usual cause behind the former is detrusor overactivity, while various combinations of detrusor overactivity, nocturnal polyuria and/or increased arousal thresholds lie behind the latter. Anatomic malformations should be suspected in the rare cases when the incontinence is continuous and does not occur in discrete portions.

Among disorders of the voiding phase, there is a spectrum of conditions with increasing severity from habitual voiding postponement through dysfunctional voiding—i.e. children who contract the sphincter during micturition—to detrusor underactivity and severe bladder and bowel dysfunction, disorders associated with a clear risk for renal damage. If the child voids with a weak stream or needs to strain to void, extra evaluation is needed in order to exclude bladder outlet obstruction or the neuropathic bladder.

Bowel function and psychology need to be taken into account in the management of almost any lower urinary tract disorder. Constipation may, for instance, cause detrusor overactivity and is usually present in children with functional or neurogenic disorders of the voiding phase. Incontinence, during the day or night, may cause psychological problems via low self-esteem, and behavioural issues may have a pathogenetic role in voiding postponement or dysfunctional voiding.

Keywords

Terminology Definitions Incontinence Enuresis Dysfunctional voiding Psychology Constipation Epidemiology Comorbidity Case history Pathogenesis Warning signs 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Uppsala University Children’s HospitalUppsalaSweden

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