Voiding Dysfunction in Children

Posted by e-Medical PPT Tuesday, July 20, 2010
Voiding dysfunction is a common problem in children and accounts for as many as 40% of pediatric urology clinic visits.It is difficult to differentiate a pathologic pattern of urgency or incontinence due to an underlying urologic abnormality from benign conditions related to incomplete or abnormal toilet training. Normal voiding frequency in children is defined as 4-7 voids per day. Voiding symptoms (eg, urgency, frequency, incontinence) reflect alterations in urinary bladder function.
Infants regularly void by detrusor muscle contraction as much as hourly, with small voided volumes and incomplete bladder emptying. With increasing age, bladder function matures and bladder capacity increases. Children aged 2-5 years have increased awareness of bladder fullness and develop the ability to volitionally void or inhibit voiding until it is socially acceptable. During this period, acquisition of cortical control of micturition occurs. Many forms of voiding dysfunction can be thought of as a delay in the acquisition of daytime urinary control, which typically occurs by age 4 years.

Voiding Dysfunctional Disorders
  • Minor Voiding Dysfunctional Disorders - Extraordinary daytime urinary frequency syndrome ,Giggle incontinence,Stress incontinence,Post void dribbling,Vaginal voiding,Primary monosymptomatic nocturnal enuresis
  • Moderate Voiding Dysfunctional Disorders - Overactive bladder/Urge Syndrome,Bladder Sphincter Dysnergia,Lazy bladder syndrome
  • Major Voiding Dysfunctional Disorders - Hinman syndrome- non neruogenic neurogenic bladder,Ochoa (urofacial) syndrome,Hinman syndrome with Autosomal dominant inheritance & facial grimace when smiling,Myogenic detrusor failure
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