Pathophysiology of Daytime Urinary Incontinence in Children

I-Ni Chiang ； Stephen Shei-Dei Yang ； Shang-Jen Chang

《Incontinence & Pelvic Floor Dysfunction》 5卷4期 (2011/12) Pp. 107-110

https://doi.org/10.6259/IPFD.2011.5.4.107

並列摘要

Daytime urinary incontinence is common in children. Children usually attain daytime bladder control before the age of 4 to 6 years. The prevalence of daytime incontinence decreases with age, although the reported prevalence figures vary widely because of differences in definition and geographic areas. According to a nationwide questionnaire study in Korea, the prevalence rates of daytime incontinence were 31.0% and 6.5% at the ages of 5 and 12 years, respectively. The International Children's Continence Society defines urinary incontinence as an involuntary loss of urine due to anatomical or functional etiology. The pathophysiology of daytime incontinence in children could be attributed to anatomical or non-anatomical factors. Anatomical factors include neurogenic bladder secondary to myelomeningocele, bladder extrophy, ectopic ureter, urethrovaginal reflux, labial adhesions and trauma. Functional causes include late toilet training, overactive bladder, dysfunctional voiding, giggle incontinence, urinary tract infections and voiding postponement. To manage children with daytime incontinence, a detailed history and physical examination is paramount. Non-invasive diagnostic tools including a urinalysis, voiding diary, uroflowmetry with a post-void residual test and/or electromyography, dysfunctional voiding symptom score, and ultrasound of the kidney and bladder may be of benefit in improving the diagnosis. Invasive complete urodynamic studies and voiding cystourethrography were usually reserved for children refractory to initial management or suspected of having a neurogenic bladder or anatomical anomaly.

並列關鍵字

children ； urinary continence ； toilet training