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Lower Urinary Tract Dysfunction in Children
Affiliation:1. Division of Urology, Washington University in St. Louis, St. Louis Children''s Hospital, St. Louis, Missouri;2. Department of Urology, Children''s Hospital and Harvard Medical School, Boston, Massachusetts;3. Pediatrics (Nephrology Section), Skejby University Hospital, Aarhus, Denmark;4. The Children''s Centre, Cabrini Hospital, Melbourne, Australia;5. New York Medical College, Valhalla, New York;6. Pediatric Urology and Nephrology, Gent University Hospital, Ghent, Belgium;7. Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany;8. Pediatrics, Evelina Children''s Hospital, St Thomas'' Hospital, London, England;9. Division of Urology, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei, and School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan;10. Section of Paediatric Nephrology, Department of Women''s and Children''s Health, Uppsala University, Uppsala, Sweden;1. Department of Urology and Pediatric Urology, Erasmus Medical Center, Rotterdam, The Netherlands;2. Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands;3. Department of Pediatrics, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands;4. Department of Pediatrics, Van Weel Bethesda Hospital, Dirksland, The Netherlands;1. Ağrı Military Hospital, Department of Urology, Ağri, Turkey;2. Gulhane Military Medical Academy, Department of Urology, Gulhane, Turkey;3. Etimesgut Military Hospital, Department of Urology, Etimesgut, Turkey;4. Gulhane Military Medical Academy, Department of Biochemistry, Gulhane, Turkey;1. McMaster Children''s Hospital, Hamilton, Ontario, Canada;2. McMaster Pediatric Surgery Research Collaborative, Hamilton, Ontario, Canada;3. Clinical Urology Research Enterprise (CURE) Program, Hamilton, Ontario, Canada;4. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada;5. The Hospital for Sick Children, Division of Urology, Toronto, Ontario, Canada
Abstract:Up to 10% of school-age children suffer from recurrent urinary tract infections (UTIs) and/or urinary incontinence. Lower urinary tract problems are, together with asthma, the most important chronic disease of the pediatric age group. Diagnosis must discriminate among those children with functional voiding problems, those with neuropathic bladders, and those with anatomic anomalies who may need surgery. In boys with overactive bladder (OAB) and incontinence, urethral obstruction must be evaluated as the possible cause. Functional incontinence with lower urinary tract symptoms (LUTS) is very common in girls and can be accompanied by UTI. In girls with dysfunctional voiding or underactive bladder, other anomalies need to be excluded because, for many of these girls, LUTS can be a chronic condition that requires lifelong attention to voiding behavior.
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