Lower urinary tract dysfunction in children with urinary incontinence

The aim of the study was to determine the incidence of lower urinary tract dysfunction in children with incontinence, and to analyse the relation between the type of the dysfunction, the clinical symptoms and radiological findings. In 232 incontinent children, residual urine was first determined by ultrasound, followed by urodynamic investigation. Clinical and radiological parameters were analysed in the three most common functional groups. The results show that incontinence in childhood is a heterogeneous disorder, mostly caused by lower urinary tract dysfunction. 64 children (27.6%) had normal function, 106 children (45.7%) had an unstable bladder, 53 children (22.8%) had dysfunctional voiding, and nine children had one of the less common urodynamic disorders. In most of the children with normal bladder function incontinence was a benign condition that could be treated at the primary care level. These children mostly had day incontinence (76.6%), without uroinfections (72%), without residual urine (100%) and VUR (97%). In children with unstable bladders and dysfunctional voiding, day and night incontinence (57% and 62%) are more common, accompanied by uroinfections (57% and 79%), residual urine (63,2% and 100%), and often VUR (30% and 55%). These children need a team approach and specific treatment dependent on the type of dysfunction, in order to prevent UTI, VUR and renal damage.