[Analisys of non-neurogenic lower urinary tract dysfunction patterns controlled in a Pediatric urodynamic unit.]

OBJECTIVES: Between 7-10% of schoolagechildren are seen by specialists for non-neurogeniclower urinary tract dysfunction (LUTD). The objective ofour study is to classify these functional alterations in difused for the diagnosis and treatment in each pattern.

MATERIAL AND METHODS: We reviewed patients referredto our Urodynamic Unit for suspected LUTD for3 years; We reviewed epidemiological data, supplementarytest and treatments. We classified these patientsaccording to their diagnosis and we stablished a LUTDpattern. We analyzed the incidence of each pattern andthe differences in the management.

RESULTS: We studied 96 patients. The mean age was7.91 years; with 53.1% children and 46.9% girls. Themost frequent symptom was diurnal urinary loss (75%),being also the most common reason for consultation(65%). 35.4% had bladder and bowel dysfunction (constipation35.4% and/or fecal incontinence 12.5%). Theprevalence of overactive bladder (56.4%), followed by:hypoactive bladder (21.9%), uncoordinated urination(6.3%), frequent urination syndrome (6.3%), urinary incontinencewith Laughter (5.2%) and post-void dribbling(2.1%). 51% of the patients presented a postponing habit.In 41.7%, the pathology was resolved with conservativemeasures. 52.1% of patients required anticholinergicsand 11.4% other therapies such as biofeedback.

CONCLUSIONS: LUTD is a common disorder that maybe underestimated. The prognosis is favorable in mostcases but serious long-term complications such as renalfailure may occur. The symptoms of LUTD can negativelyaffect the child's psychosocial development. The advancesin the knowledge of this pathology and the differentpatterns of dysfunction have allowed an advance inthe treatment, making it more and more behavioral andpreventive. Patients who do not improve with standardurotherapy recommendations should be referred to specificunits for proper diagnosis and treatment.