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Categories of bladder dysfunction disorders

Categories of bladder dysfunction disorders
Urinary incontinence disorders in children Typical characteristics
Nocturnal enuresis  
Daytime urinary continence disorders
Overactive bladder Urinary urgency, often with frequency and nocturia, without UTI. May lead to urgency incontinence.
Voiding postponement Habitual postponement of voiding, sometimes with holding maneuvers. If chronic, may lead to underactive bladder.
Underactive bladder Straining to initiate or complete voiding due to poor or absent bladder contraction. May have interrupted urine flow pattern.
Dysfunctional voiding Inability to relax the urethral sphincter and/or pelvic floor musculature during voiding, without an underlying neurogenic cause. Urine flow is in a staccato pattern, and there is a prolonged voiding time.
Other conditions
  • Vaginal reflux
Incontinence in toilet-trained females that occurs when they stand up after voiding. It is caused by temporary entrapment of urine into the vagina, often because the legs were held very close together during voiding. May have associated labial irritation or adhesions.
  • Giggle incontinence
Rare condition characterized by incontinence that is only associated with laughing.
  • Extraordinary daytime-only urinary frequency
Very frequent daytime voiding (greater than once/hour) with small voided volumes that is not caused by an underlying disorder (eg, polyuria, UTI).
  • Bladder neck dysfunction
Delayed or incomplete opening of the bladder neck during voiding. Symptoms include hesitancy, frequency, urgency, weak urinary stream, pelvic pain or discomfort during voiding, sense of incomplete emptying, and occasional nocturnal enuresis.
UTI: urinary tract infection.
Reference:
  1. Austin PF, Bauer SB, Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents: Update report from the Standardization Committee of the International Children's Continence Society. J Urol 2014; 191:1863.
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