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50 - Non-neuropathic bladder–sphincter dysfunction

from Part V - Urology

Published online by Cambridge University Press:  08 January 2010

Göran Läckgren
Affiliation:
Section of Urology, University Children's Hospital, Uppsala, Sweden
Tryggve Nevéus
Affiliation:
Department of Pediatrics, University Children's Hospital, Uppsala, Sweden
Mark D. Stringer
Affiliation:
University of Otago, New Zealand
Keith T. Oldham
Affiliation:
Children's Hospital of Wisconsin
Pierre D. E. Mouriquand
Affiliation:
Debrousse Hospital, Lyon
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Summary

Background

Bladder dysfunction and nocturnal enuresis are the most common urological disorders in children. The development of continence and voluntary voiding requires maturation of the neural system and the establishment of sound micturition habits. While the conscious sensation of bladder fullness is usually gained during the second year of life, the ability to void and also to inhibit voiding develops 1–2 years later. Consequently, most healthy children become dry during this period of life. By 4 years of age 75% of all children have attained bladder control and can consciously start, postpone or interrupt voiding. Nocturnal dryness is generally achieved later than daytime bladder control.

Healthy schoolchildren void 3–7 times/day, and most of them empty their bladders completely, without residual urine. There is, however, a substantial minority of at least 20% of 7-year old children who have signs of incomplete bladder control, i.e., symptoms of either “non-neuropathic bladder–sphincter dysfunction” or nocturnal enuresis.

When taking a history in incontinent children over 5 years of age, the severity, frequency and timing of wetting episodes should be described, as well as whether the accidents are preceded by urgency or associated with holding maneuvers. Bowel function should also be assessed. The use of a bladder diary is strongly recommended, since it is the only method of recording incontinent episodes as well as times of micturition, voided volumes, pad usage as well as fluid intake, the degree of urgency and the degree of incontinence.

Type
Chapter
Information
Pediatric Surgery and Urology
Long-Term Outcomes
, pp. 643 - 651
Publisher: Cambridge University Press
Print publication year: 2006

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References

Abidari, J. M. & Shortliffe, L. M. D.Urinary incontinence in girls. Urol. Clin. N. Am. 2002; 29:661–675.CrossRefGoogle ScholarPubMed
Bloom, D. A., Faerber, G., & Bomalaski, M. D.Urinary incontinence in girls. Evaluation, treatment, and its place in the standard model of voiding dysfunctions in children. Urol. Clin. North. Am. 1995; 22(3):521–38.Google ScholarPubMed
Hjalmas, K., Arnold, T., Bower, W.et al. on behalf of the International Children's Continence Society (ICCS). Nocturnal enuresis: an international evidence based management strategy. J. Urol. 2004; 171:2545–2561.CrossRefGoogle ScholarPubMed
Rushton, G.Wetting and functional voiding disorders. Urol. Clin. North Am. 1995; 22:75–93.Google ScholarPubMed
Bloom, D. A., Sweley, W. M., Ritchey, M. L., & McGuire, E. J.Toilet habits and continence in children: an opportunity sampling in search of normal parameters. J. Urol. 1993; 149:1087–90.CrossRefGoogle ScholarPubMed
Mattsson, S.Urinary incontinence and nocturia in healthy schoolchildren. Acta Pediatr. 1994; 83:950–4.CrossRefGoogle ScholarPubMed
Bakker, E., Sprundel, M., Auwera, J. C., Goold, J. D., & Wyndaele, J. J.Voiding habits and wetting in a population of 4,332 Belgian schoolchildren aged between 10 and 14 years. Scand. J. Urol. Nephrol. 2002; 36(5):354–362.CrossRefGoogle Scholar
Hellstrom, A. L., Hanson, E., Hansson, S., Hjalmas, K., & Jodal, U.Micturition habits and incontinence in 7-year-old Swedish school entrants. Eur. J. Pediatr. 1990; 149:434–437.CrossRefGoogle ScholarPubMed
Kajiwara, M., Inoue, K., Usui, A., Kurihara, M., & Usui, T.The micturition habits and prevalence of daytime urinary incontinence in Japanese primary school children. J. Urol. 2004; 171(1):403–407.CrossRefGoogle ScholarPubMed
Nevéus, T., Hetta, J., Cnattingius, S.et al. Depth of sleep and sleep habits among enuretic and incontinent children. Acta Pædiatr. 1999; 88:748–752.CrossRefGoogle ScholarPubMed
Sureshkumar, P., Bower, W., Craig, J. C., & Knight, J. F.Treatment of daytime urinary incontinence in children: a systematic review of randomized controlled trials. J. Urol. 20003; 170(1):196–200, discussion 200.CrossRefGoogle Scholar
Sureshkumar, P., Craig, J. C., Roy, L. P., & Knight, J. F.Daytime urinary incontinence in primary school children: a population-based survey. J. Pediatr. 2000; 137(6):814–818.CrossRefGoogle ScholarPubMed
Meadow, S. R.Day wetting. Pediatr. Nephrol. 1990; 4:178–184.CrossRefGoogle ScholarPubMed
Abrams, P., Cardozo, L., Fall, M.et al.The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol. Urodyn. 2002; 21:167–178.CrossRefGoogle ScholarPubMed
Hjälmås, K.Urinary incontinence in children: suggestions for definitions and terminology. Scand. J. Urol. Nephrol. Suppl., 1992; 141:1.Google ScholarPubMed
Cheater, F. M. & Castleden, C. M.Epidemiology and classification of urinary incontinence. Clin. Obstet. Gynaecol. 2000; 14:183.Google ScholarPubMed
Nijman, R.Classification and treatment of functional incontinence in children. Br. J. Urol. 2000; 85 Suppl. 3:43–46.CrossRefGoogle ScholarPubMed
Swithinbank, L. V., Brookes, S. T., Shepherd, A. M., & Abrams, P. H.The natural history of urinary symptoms during adolescence. Br. J. Urol. Suppl. 1998; 81:90.CrossRefGoogle ScholarPubMed
Knudsen, U. B., Rittig, S., N⊘rgaard, J. P., Lundemose, J. B., Pedersen, E. B., & Djurhuus, J. C.Long-term treatment of nocturnal enuresis with desmopressin. A follow-up study. Urol. Res. 1991; 19(4):237–240.CrossRefGoogle ScholarPubMed
Hansen, A., Hansen, B., & Dahm, T. L.Urinary tract infection, day wetting and other voiding symptoms in seven- to eight-year-old Danish children. Acta Paediatr. 1997; 86(12):1345–1349.CrossRefGoogle ScholarPubMed
Hampel, C., Wienhold, D., Benken, N., Eggersmann, C., & Thurhoff, J. W.Definition of overactive bladder and epidemiology of urinary incontinence. Urology 1997; 50:4.CrossRefGoogle ScholarPubMed
Hannestad, Y. S., Rortveit, G., Sandvik, H., & Hunskaar, S.A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. J. Clin. Epidemiol. 2000; 53:1150.CrossRefGoogle ScholarPubMed
Stewart, W., Herzog, A. R., Wein, A. et al. Prevalence of overactive bladder in the US: results from the NOBLE program. 2nd International Consultation on Incontinence, abstract no 79, Paris 2001.
Swithinbank, L. V., Donovan, J. L., Du Heaume, J. C.et al.Urinary symptoms and incontinence in women: relationships between occurrence, age, and perceived impact. Br. J. Gen. Pract. 1999; 49:897.Google ScholarPubMed
Rittig, S., Knudsen, U. B., N⊘rgaard, J. P., Pedersen, E. B., & Djurhuus, J. C.Abnormal diurnal rhythm of plasma vasopressin and urinary output in patients with enuresis. Am. J. Physiol. 1989; 256:F664–F671.Google ScholarPubMed
Yeung, C. K., Chiu, H. N., & Sit, F. K.Bladder dysfunction in children with refractory monosymptomatic primary nocturnal enuresis. J. Urol. 1999; 162(3 Pt 2):1049–1055.CrossRefGoogle ScholarPubMed
Wolfish, N. M., Pivik, R. T., & Busby, K. A.Elevated sleep arousal thresholds in enuretic boys: clinical implications. Acta Pædiatr. 1997; 86:381–384.CrossRefGoogle ScholarPubMed
Tuvemo, T.DDAVP in childhood nocturnal enuresis. Acta Pædiatr. Scand. 1978; 67:753–755.CrossRefGoogle ScholarPubMed
Wille, S.Comparison of desmopressin and enuresis alarm for nocturnal enuresis. Arch. Dis. Child. 1986; 61:30–33.CrossRefGoogle ScholarPubMed
Lovering, J. S., Tallett, S. E., & McKendry, B. I.Oxybutynin efficacy in the treatment of primary enuresis. Pediatrics 1988; 82; 104–106.Google ScholarPubMed
Hjälmås, K., Hoebeke, P. B., & dePaepe, H.Lower urinary tract dysfunction and urodynamics in children. Eur. Urol. 2000; 38:655.Google ScholarPubMed
Hjalmas, K., Hellstrom, A. L., Mogren, K., Lackgren, G., & Stenberg, A.The overactive bladder in children: a potential future indication for tolterodine. BJU Int. 2001; 87:569–574.CrossRefGoogle ScholarPubMed
Hellstrom, A., Hanson, E., Hansson, S., Hjalmas, K., & Jodal, U.Micturition habits and incontinence at age 17 -reinvestigation of a cohort studied at age 7. Br. J. Urol. 1995; 76(2):231–234.CrossRefGoogle ScholarPubMed
Lettgen, B., Gontard, A., Olbing, H., Heiken-Löwenau, C., Gaebel, E., & Schmitz, I.Urge incontinence and voiding postponement in children: somatic and psychosocial factors. Acta Pædiatr. 2002; 91:978–984.CrossRefGoogle ScholarPubMed
Hoebeke, P., Laecke, E., Camp, C., Raes, A., & Walle, J.One thousand video-urodynamic studies in children with non-neurogenic bladder sphincter dysfunction. BJU Int. 2001; 87:575–580.CrossRefGoogle ScholarPubMed
Allen, T. D. Vesicoureteral reflux as a manifestation of dysfunctional voiding. In Hodson, J. & Kincaid-Smith, P. eds. Reflux Nephropathy. Chapter 18, New York: Masson Publishing Co, 1979:171–180.Google ScholarPubMed
Bauer, S. B.Special considerations of the overactive bladder in children. Urology 2002; 60(5 Suppl 1):43–48; discussion 49.CrossRefGoogle ScholarPubMed
Chiozza, M. L.Dysfunctional voiding. Pediatr. Med. Chir. 2002; 24(2):137–140.Google ScholarPubMed
Gontard, A.Enkopresis: Erscheinungsformen – Diagnostik – Therapie. Stuttgart: Kohlhammer Verlag, 2004.Google Scholar
Hansson, S.Urinary incontinence in children and associated problems. J. Urol. Nephrol. Suppl. 1992; 141:47–55.Google ScholarPubMed
Hoebeke, P., Renson, C., Raes, A., Vanlaecke, E., & Walle, J.Pelvic floor spasms in children: an unknown condition responding well to pelvic floor therapy. BJU Int. 2003; 91 Suppl 1:19.Google Scholar
Hobeke, P.New insights in diagnosis and treatment of non-neuropathic bladder-sphincter dysfunction in children. Thesis. Gent. 1998.Google Scholar
Hellstöm, A.-L., , Hanson, E., Hansson, S., Hjälmås, K., & Jodal, U.Association between urinary symptoms at 7 years old and previous urinary tract infection. Arch. Dis. Child. 1991; 66:232–234.CrossRefGoogle Scholar
Hansson, S., Hjalmas, K., Jodal, U., & Sixt, R.Lower urinary tract dysfunction in girls with untreated asymptomatic or covert bacteriuria. J. Urol. 1990; 143:333–335.CrossRefGoogle ScholarPubMed
Koff, S. A.Relationsship between dysfunctional voiding and reflux. J. Urol. 1992; 148:1703–1705.CrossRefGoogle Scholar
Sillén, U., Hjälmås, K., Aili, M., Bjure, J., Hansson, E., & Hansson, S.Pronunced detrusor hypercontractility in infants with gross bilateral reflux. J. Urol. 1992; 148:598.CrossRefGoogle Scholar
Snodgrass, W.Relationship of voiding dysfunction to urinary tract infection and vesicoureteral reflux in children. Urology 1991; 38:341–344.CrossRefGoogle ScholarPubMed
Läckgren, G. & Stenberg, A.Bladder dysfunction and VUR. Result of endoscopic treatment with Deflux. Abstract. ICCS Hongkong, 2002.Google Scholar
Hellstrom, A. L., Hjalmas, K., & Jodal, U.Rehabilitation of the dysfunctional bladder in children: method and 3-year follow-up. J. Urol. 1987; 138:847–849.CrossRefGoogle Scholar
Hobeke, P., Walle, J., Theunis, M., Paepe, H., & Oosterlinck, , Renson, C.Outpatient pelvic floor therapy in girls with daytime incontinence and dysfunctional voiding. Urology 1996; 48:923–927.CrossRefGoogle Scholar
Vijverberg, M. A., Elzinga-Plomp, A., Messer, A. P., Gool, J., & Jong, T. P.Bladder rehabilitation, the effect of a cognitive training programme on urge incontinence. Eur. Urol. 1997; 31:68–72.CrossRefGoogle ScholarPubMed
Kuh, D., Cardozo, L., & Hardy, R.Urinary incontinence in middle aged women: childhood enuresis and other lifetime risk factors in a British prospective cohort. J. Epidemiol. Commun. Health 1999; 53(8):453–458.CrossRefGoogle Scholar
Soderstrom, U., Hoelcke, M., Alenius, L., Soderling, A. C., Hjern, A.Urinary and faecal incontinence: a population-based study. Acta Paediatr. 2004; 93(3):386–389.CrossRefGoogle ScholarPubMed
Hjälmås, K., Hanson, E., Hellström, A.-L., , Kruse, S., & Sillén, U.Long-term treatment with desmopressin in children with primary monosymptomatic nocturnal enuresis: an open multicentre study. Swedish Enuresis Trial (SWEET) Group. Br. J. Urol. 1998; 82(5):704–709.CrossRefGoogle ScholarPubMed
Reinberg, Y., Crocker, J., Wolper, J., & Vandersten, D.Therapeutic efficacy of extended release oxybutynin chloride, and immediate release and long acting tolterodine tartrate in children with diurnal urinary incontinence. J. Urol. 2003; 169:317–319.CrossRefGoogle ScholarPubMed
Hunskaar, S.One hundred and fifty men with urinary incontinence. I. Demography and medical history. Scand. J. Prim. Health Care 1992; 10:21.CrossRefGoogle ScholarPubMed
Hunskaar, S., Burgio, K., Diokno, A., Herzog, A. R., Hjalmas, K., & Lapitan, M. C.Epidemiology and natural history of urinary incontinence inwomen. Urology 2003; 62:16–23.CrossRefGoogle Scholar
Samuelsson, E., Victor, A., Tibblin, G.A population study of urinary incontinence and nocturia among women aged 20–59 years. Prevalence, well-being and wish for treatment. Acta Obstet. Gynecol. Scand. 1997; 76:74.CrossRefGoogle Scholar
Yarnell, J. W., Voyle, G. J., Richards, C. J., & Stephenson, T. P.The prevalence and severity of urinary incontinence in women. J. Epidemiol. Commun. Health 1981; 35:71.CrossRefGoogle ScholarPubMed
Kalo, B. B. & Bella, H.Enuresis: prevalence and associated factors among primary school children in Saudi Arabia. Acta. Pædiatr. 1996; 85:1217–1222.CrossRefGoogle ScholarPubMed
Laberge, L., Tremblay, R. E., Vitaro, F., & Montplaisir, J.Development of parasomnias from childhood to early adolescence. Pediatrics 2000; 106:67–74.CrossRefGoogle ScholarPubMed
Wal, M. E., Pauw-Plomp, H., & Schulpen, T. W.Bedplassen bij Nederlandse, Surinaamse, Marokkanse en Turkse kinderen van 3–4, 5–6 enl 11–12 jaar. Ned. Tijdschr. Geneeskd. 1996; 140(48):2410–2414.Google Scholar
Marugan de Miguelsanz, J. M., Lapena Lopez de Armentia, S., Rodriguez Fernandez, L. M.et al.Analisis epidemiologico de la secuencia de control vesical y prelvalencia de enuresis nocturna en ninos de la provincia de leon. An. Esp. Pediatr. 1996; 44(6):561–567.Google Scholar
Forsythe, W. I. & Redmond, A.Enuresis and spontaneous cure rate: study of 1129 enuretics. Arch. Dis. Child. 1974; 49:259–263.CrossRefGoogle Scholar
Monda, J. M. & Husmann, D. A.Primary nocturnal enuresis: a comparison among, observation., imipramine, desmopressin acetate and bed-wetting alarm systems. J. Urol. 1995; 154(2 Pt 2):745–748.CrossRefGoogle ScholarPubMed
Hirasing, R. A., Leerdam, F. J., Bolk-Bennink, L., & Janknegt, R. A.Enuresis nocturna in adults. Scand. J. Urol. Nephrol. 1997; 31(6):533–536.CrossRefGoogle ScholarPubMed
Aladjem, M., Wohl, R., Boichis, H., Orda, S., Lotan, D., & Freedman, S.Desmopressin in nocturnal enuresis. Arch. Dis. Child. 1982; 57:137–140CrossRefGoogle ScholarPubMed
Fjellestad-Paulsen, A., Laborde, K., Kindermans, C., & Czernichow, P.Water-balance hormones during long-term follow-up of oral DDAVP treatment in diabetes insipidus. Acta Pædiatr. 1993; 82(9):752–757.CrossRefGoogle ScholarPubMed
Läckgren, G., Nevéus, T., Lilja, B., & Stenberg, A.Desmopressin in the treatment of severe nocturnal enuresis in adolescents – a 7-year follow-up study. Br. J. Urol. 1998; 81(Suppl 3):17–23.CrossRefGoogle ScholarPubMed
Berg, I. B., Forsythe, W. I., & McGuire, R.Response of bed wetting to the enuresis alarm: influence of psychiatric disturbance and maximum functional bladder capacity. Arch. Dis. Child. 1982; 57:394–396.CrossRefGoogle ScholarPubMed
Bollard, J. & Nettelbeck, T.A comparison of dry-bed training and standard urine-alarm conditioning treatment of childhood bedwetting. Beh. Res. Ther. 1981; 19(3):215–226.CrossRefGoogle ScholarPubMed
Devlin, J. B. & O'Cathain, C.Predicting treatment outcome in nocturnal enuresis. Arch. Dis. Child. 1990; 65(10):1158–1161.CrossRefGoogle ScholarPubMed
El-Anany, F. G., Maghraby, H. A., Shaker, S. E., & Abdel-Moneim, A. M.Primary nocturnal enuresis: a new approach to conditioning treatment. Urology 1999; 53(2):405–409.CrossRefGoogle ScholarPubMed
Bengtsson, B.Sök hjälp tidigt för barn med enures. Råd från vuxna som haft svår nattväta som barn. Läkartidningen 1997; 94(4):245–246.Google Scholar
Swithinbank, L. V., Carr, J. C., & Abrams, P. H.Longitudinal study of urinary symptoms in children. Scand. J. Urol. Nephrol. Suppl. 1994; 163:67.Google ScholarPubMed
Yang, C. C. & Mayo, M. E.Morbidity of NNBSB syndrome. Urology 1997; 49:445–448.CrossRefGoogle ScholarPubMed
Foldspang, A. & Mommsen, S.Adult female urinary incontinence and childhood bedwetting. J. Urol. 1994; 152(1):85–88.CrossRefGoogle ScholarPubMed
Moore, K. H., Richmond, D. H., & Parys, B. T.Sex distribution of adult idiopathic detrusor instability in relation to childhood bed-wetting. Br. J. Urol. 1991; 68:479–482.CrossRefGoogle Scholar
Holst, K. & Wilson, P. D.The prevalence of female urinary incontinence and reasons for not seeking treatment. N. Z. Med. J. 1988; 101:756.Google Scholar
Hägglöf, B., Andrén, O., Bergström, E., Marklund, L., & Wendelius, M.Self-esteem before and after treatment in children with nocturnal enuresis and urinary incontinence. Scand. J. Urol. Nephrol. 1997; 31(Suppl. 183):79–82.Google Scholar
Schulman, S. L., Quinn, C. K., Plachter, N., & Kodman-Jones, C.Comprehensive management of dysfunctional voiding. Pediatrics 1999; 103(3):E31.CrossRefGoogle ScholarPubMed

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