title: Voiding postponement in children-a systematic review.
abstract: Voiding postponement (VP) has been defined as a habitual postponement of micturition using holding maneuvers. VP can represent both a symptom, as well as a condition. As divergent definitions are used internationally, the aim was to review the current state of knowledge on VP and provide recommendations for assessment, diagnosis and treatment. A Scopus and a Pubmed search was conducted, entering the terms 'voiding postponement' without any restrictions or specifications. Other publications relevant to the topic were added. VP can represent a symptom in healthy children. As a condition, VP in combination with nocturnal enuresis (NE) is a subtype of non-monosymptomatic NE. Most studies have focused on daytime urinary incontinence (DUI) with VP, or more aptly termed voiding postponement incontinence (VPI). It is a behaviorally defined syndrome, i.e., by the habitual deferral of micturition and DUI. VPI is associated with a low micturition frequency, urgency and behavioral problems. The most common comorbid disorder is oppositional defiant disorder (ODD). VP as a symptom and VPI as a condition should be differentiated. VPI is a common disorder with many associated problems and disorders. Urotherapy and timed voiding are the main treatment approaches. Due to the high rate of comorbid ODD, other forms of treatment, especially cognitive behavioral therapy, are often needed.
authors.affiliation: Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421, Homburg, Germany. alexander.von.gontard@uniklinikum-saarland.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: von Gontard
authors.affiliation: Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421, Homburg, Germany.
authors.forename: Justine
authors.initials: J
authors.lastname: Niemczyk
authors.affiliation: Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421, Homburg, Germany.
authors.forename: Catharina
authors.initials: C
authors.lastname: Wagner
authors.affiliation: Department of Clinical Psychology, Saarland University, Saarbrücken, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Equit
mesh_terms: D019958:Attention Deficit and Disruptive Behavior Disorders / Q000523:psychology*; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D006801:Humans; D014555:Urination Disorders / Q000523:psychology*
keywords: Daytime urinary incontinence; Non-monosymptomatic nocturnal enuresis; Oppositional defiant disorder; Voiding postponement