Significant strides have been made over the past two decades in more precisely evaluating and managing children with voiding complaints. A thorough history should offer insight into the possible causes for the presenting complaints and this is supplemented by physical examination, urine studies and select imaging.
Uroflowmetry and external sphincter electromyography with measurement of post-void residual urine should allow for accurate diagnosis using categories offered by the International Children's Continence Society. This ability to make an accurate diagnosis should naturally lead to the use of treatment options (urotherapy, pharmacotherapy, biofeedback, and neuromodulation) that specifically target the responsible cause of the complaints rather than simply their symptoms.
Urology. 2016 Feb 13 [Epub ahead of print]
Lane S Palmer
Division of Pediatric Urology, Cohen Children's Medical Center of New York, Hofstra North Shore-LIJ School of Medicine, Long Island, New York; Pediatric Urology Associates, PC, Long Island, New York.