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Daytime Lower Urinary Tract Conditions

  • Marleen van den Heijkant
Chapter
Part of the Urodynamics, Neurourology and Pelvic Floor Dysfunctions book series (UNPFD)

Abstract

Daytime lower urinary tract (LUT) dysfunction is the term used in the International Children’s Continence Society (ICCS) report on the standardization of terminology of LUT function in children and adolescents. Pathology like neurogenic bladder or upper and lower urinary tract uropathy should be excluded. Since there is a close relationship with bowel emptying problems in these children, the term bladder and bowel dysfunction (BBD) is used to cover both daytime LUT dysfunction and bowel dysfunction.

Diagnostic evaluation includes meticulous assessment of medical history taking from both the child and the parents making use of bladder and bowel diaries and standardized questionnaires. Clinical examination, urinalysis, uroflowmetry, and ultrasonography are usually sufficient to diagnose the condition. Incidentally, a (video) urodynamic investigation, a cystoscopy, or MRI could be necessary.

Daytime LUT conditions can be divided into storage dysfunction and voiding dysfunction. Storage dysfunction includes overactive bladder and underactive bladder eventually with voiding postponement. Voiding dysfunction consists of dysfunctional voiding, bladder outlet obstruction, and other conditions like vaginal reflux, giggling incontinence, and bladder neck dysfunction. Other LUT conditions include valve-bladder syndrome and severe BBD, historically called Hinman syndrome or nonneurogenic neurogenic bladder. Some conditions may involve over time, but for several conditions, early recognition, long-term follow-up, and management are important to ensure good voiding behavior.

Keywords

Daytime lower urinary tract conditions Bladder and bowel dysfunction Overactive bladder Underactive bladder Voiding postponement Hinman syndrome Nonneurogenic neurogenic bladder Dysfunctional voiding valve-bladder syndrome Giggle incontinence Vaginal reflux Bladder outlet obstruction Posterior urethral valves Meatus deformities Bladder neck dysfunction 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UrologyUZ LeuvenGasthuisberg, LeuvenBelgium

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