title: Clinical course of a cohort of children with non-neurogenic daytime urinary incontinence symptoms followed at a tertiary center.
abstract: OBJECTIVE
  To characterize a cohort of children with non-neurogenic daytime urinary incontinence followed-up in a tertiary center.
  
  
  METHODS
  Retrospective analysis of 50 medical records of children who had attained bladder control or minimum age of 5 years, using a structured protocol that included lower urinary tract dysfunction symptoms, comorbidities, associated manifestations, physical examination, voiding diary, complementary tests, therapeutic options, and clinical outcome, in accordance with the 2006 and 2014 International Children's Continence Society standardizations.
  
  
  RESULTS
  Female patients represented 86.0% of this sample. Mean age was 7.9 years and mean follow-up was 4.7 years. Urgency (56.0%), urgency incontinence (56.0%), urinary retention (8.0%), nocturnal enuresis (70.0%), urinary tract infections (62.0%), constipation (62.0%), and fecal incontinence (16.0%) were the most prevalent symptoms and comorbidities. Ultrasound examinations showed alterations in 53.0% of the cases; the urodynamic study showed alterations in 94.7%. At the last follow-up, 32.0% of patients persisted with urinary incontinence. When assessing the diagnostic methods, 85% concordance was observed between the predictive diagnosis of overactive bladder attained through medical history plus non-invasive exams and the diagnosis of detrusor overactivity achieved through the invasive urodynamic study.
  
  
  CONCLUSIONS
  This subgroup of patients with clinical characteristics of an overactive bladder, with no history of urinary tract infection, and normal urinary tract ultrasound and uroflowmetry, could start treatment without invasive studies even at a tertiary center. Approximately one-third of the patients treated at the tertiary level remained refractory to treatment.
authors.affiliation: Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil. Electronic address: adrienne.lebl@gmail.com.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Lebl
authors.affiliation: Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
authors.forename: Simone Nascimento
authors.initials: SN
authors.lastname: Fagundes
authors.affiliation: Pediatric Nephrology Unit, Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
authors.forename: Vera Hermina Kalika
authors.initials: VH
authors.lastname: Koch
mesh_terms: D002648:Child; D015331:Cohort Studies; D053207:Diurnal Enuresis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D053201:Urinary Bladder, Overactive / Q000150:complications* / Q000175:diagnosis
keywords: Child; Criança; Diagnosis; Diagnóstico; Incontinência urinária; Pediatria; Pediatrics; Qualidade de vida; Quality of life; Sistema urinário; Urinary incontinence; Urinary tract