Normal voiding pattern and bladder dysfunction in infants and children

The normal voiding pattern and bladder dysfunction including neurogenic and non-neurogenic bladder, nocturnal enuresis and the relation between constipation and the bladder dysfunction has been reviewed in this paper. The dynamic property of lower urinary tract is complex as mature bladder function takes place in growth of the child. Recent studies have shown that cortical centre is responsible for the arousal reaction associated with voiding reflex in both healthy preterm and normal infants indicated that the mechanism involved in the infantile voiding is unclear. Neurogenic and nonneurogenic bladder dysfunction widespread occurred in childhood. Etiology of most bladder dysfunction in many aspects is still unclear, although a lot of fundamental and clinical researches have been performed. The most prominent symptoms of bladder dysfunction are urinary infection, urgency, frequency, fractional voiding, underactive bladder syndrome, and urinary incontinence. The applicability of urodynamic testing has become an essential element in the evaluation of bladder dysfunction. Based on urodynamic parameters, the natural outcome of the early functional investigation has been the advocacy of early aggressive management of children who are in the risk of renal deterioration. Classifying the bladder dysfunction only urodynamically is insufficient and the specific information is needed about the disease. The international Children’s Continence Society has suggested a functional urodynamic classification system. The detailed knowledge of the bladder dysfunction and their treatment, are still limited in many aspects and further research is necessary in the future. [Life Science Journal. 2007; 4(4): 1 – 9] (iSSN: 1097 – 8135).