Urinary Incontinence

Abstract

Urinary incontinence is one of the commonest complaints for which children are brought to the urologist, and during the past years methods of investigation have developed in many ways. Clearly, however, the great majority of incontinent children will be “simple enuretics” and it is a matter of concern that unnecessary investigations should be avoided in these, while at the same time ensuring that those with serious and remediable disease should not be overlooked. The literature of enuresis contains records of a great many investigations, some wide ranging studies aimed at discovering the cause of enuresis as a whole; others more restricted, aimed at separating off from the morass of enuresis specific causes of urinary incontinence. The general studies have covered most aspects of the child’s physiological and psychological existence and have often reported positive results without contributing very much to our understanding of the condition or its treatment, as, for instance, the report by Campbell and Young (1966) who found electro-encephalographic disturbance in 42 per cent of enuretic children during sleep. The specifically urological investigations have been endoscopic, radiological and urodynamic: enuresis has been ascribed to inflammatory changes in the urethral mucosa, to ill-defined obstructions and folds in the urethra seen on micturating cystograms and to a variety of abnormalities in the response of the bladder muscle to distension.