FUNCTIONAL DIAGNOSTICS OF LOWER URINARY TRACT IN CHILDREN

Abstract

Lower urinary tract dysfunction is clinically relevant because it may cause urinary tract infections, mainly due to accumulation of residual urine, adversely affect renal function, and may cause urine incontinence that strongly affects the child’s quality of life. The function of the lower urinary tract is closely associated with that of the bowel, as constipation is commonly associated with bladder dysfunction. Detrusor overactivity, a benign but socially harmful condition, is the leading cause of daytime urinary incontinence in child-hood and needs to be differentiated from more severe conditions such as neurogenic bladder dysfunction or urethral obstruction. Voiding dysfunction, a habitual sphincter con-traction during voiding, is common in children with detrusor overactivity and may be self-limiting but may also result in residual urine and urinary tract infections. It may resemble, in severe cases, the neurogenic bladder dysfunction, most often caused by spinal dysraphism, which is characterized by several subtypes of lower urinary tract dysfunction. This condition very often leads to recurrent urinary tract infections and high intravesical pressures, threatening kidney function. A voiding diary is crucial in the initial evaluation of lower uri-nary tract function in children.

Keywords

• voiding disorders
• urinary incontinence
• lower urinary tract
• children
• voiding diary
• urodynamics