Recommendations for the Management of Bladder Bowel Dysfunction in Children

Bladder and bowel dysfunction in children: An update on the diagnosis and treatment of a common, but underdiagnosed pediatric problem

“…1,8,9 Other symptoms, such as dysuria, stream changes, daytime incontinence, enuresis, excessive fluid intake, and increased urinary volume are usually not present. Unlike other categories of voiding dysfunction, which are more frequent in girls by a 5:1 ratio, extraordinary daytime frequency invariably occurs in young boys and is selflimited.…”

“…Unlike other categories of voiding dysfunction, which are more frequent in girls by a 5:1 ratio, extraordinary daytime frequency invariably occurs in young boys and is selflimited. 1,10,11 Underactive bladder This urological condition is characterized by infrequent voiding, typically 2-4 times daily, and straining during micturition. Typically, children with underactive bladder (UB) voluntarily bend over or push the abdomen, in attempt to increase intra-abdominal pressure and start or complete voiding.…”

“…BBD describes a myriad of lower urinary symptoms (LUTS), accompanied by bowel complaints, primarily constipation and/or encopresis, and represents up to 40% of pediatric urology consults. 1,2 LUTS symptoms common to BBD include dysuria, urgency, urinary frequency, hesitancy, daytime incontinence, enuresis, dribbling, straining, voiding postponement, and urinary retention. Urological conditions such as overactive bladder (OAB), underactive bladder, and dysfunctional voiding can be part of BBD.…”

“…BBD cycle pattern is established when children who hold their bladders by choice for longer periods exhibit reduced sensation to evacuate, ultimately resulting in constipation and/or encopresis. 1 BBD is a potential cause of significant physical and psychosocial burden for children and families. It is commonly associated with vesicoureteral reflux (VUR) and recurrent urinary tract infections (UTIs), which ultimately may lead to renal scarring and kidney failure.…”

“…It is commonly associated with vesicoureteral reflux (VUR) and recurrent urinary tract infections (UTIs), which ultimately may lead to renal scarring and kidney failure. [1][2][3][4] BBD negatively affects children's quality of life and self-esteeml; therefore, early diagnosis and treatment of BBD are critical to avoid secondary comorbidities that can adversely impact children's kidney and bladder function, as well as their psychosocial well-being.…”