Non-neurogenic elimination disorders in children.
Non-neurogenic elimination disorders cover a wide spectrum of lower urinary tract and bowel dysfunctions, observed in the absence of a neurological background or lower urinary tract malformation. We reviewed conditions responsible for incontinence during bladder filling with normal voiding patterns (such as overactive bladder, giggle incontinence, post-void dribbling), and dysfunctional voiding syndromes. Dysfunctional elimination syndrome usually includes detrusor-sphincter dyscoordination, small-capacity overactive bladder or decompensated large poorly contractile bladder, and large-volume post-micturition residuals, occasionally associated with bowel dysfunction. At the most severe end of the spectrum lies the non-neurogenic neurogenic bladder syndrome, characterized by the association of a severe impairment of the upper urinary tract with a dysfunctional elimination syndrome. It must be emphasized that if the term 'non-neurogenic' relates to the absence of a neurological lesion, it is however conceivable that these conditions actually do have an underlying neurological cause that remains to be identified.
Paediatric Surgery and Urology Department, Hopital Mère-Enfant, CHU de NANTES, 44 093 Nantes Cedex, France. mdleclair@chu-nantes.fr
Marc-David
MD
Leclair
Yves
Y
Héloury
D002648:Child; D006801:Humans; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000628:therapy; D014549:Urinary Incontinence / Q000209:etiology / Q000628:therapy; D014555:Urination Disorders / Q000209:etiology / Q000628:therapy