![]() ![]() Bladder ultrasonography to measure post-void residual urine volume and urodynamics are used as supplemental tests. Bladder diaries are important for recording urinary frequency and water balance, while uroflowmetry is used to assess voided volume, maximum flow, and curve patterns. Physical examination focuses on the abdomen to investigate a distended bladder or palpable fecal mass, the lumbosacral spine, and reflex testing. Dysfunctional Voiding Score System (DVSS) is a helpful tool. Diagnosis of LUTD is essentially based on clinical history, investigation of bladder storage, voiding symptoms (urinary frequency, daytime incontinence, enuresis, urgency) and constipation. LUTD is often associated with constipation and emotional/behavioral disorders such as anxiety, depression, aggressiveness, and social isolation, making diagnosis, and treatment imperative. ![]() LUTD may lead to vesicoureteral reflux and recurrent urinary tract infections, increasing the likelihood of renal scarring. The clinical spectrum is wide and includes overactive bladder, voiding postponement, underactive bladder, infrequent voiding, extraordinary daytime only urinary frequency, vaginal reflux, bladder neck dysfunction, and giggle incontinence. ![]() However, in 17–22% of children, symptoms persist beyond that age, characterizing lower urinary tract dysfunction (LUTD). These maturational sequences are clinically evident by the age of 5 years. Normal bladder and urethral sphincter development as well as neural/volitional control over bladder-sphincter function are essential steps for regular lower urinary tract function. 1Center of Urinary Disorders in Children (CEDIMI), Bahiana School of Medicine and Federal University of Bahia, Salvador, Brazil.Mirgon Fuentes 1, Juliana Magalhães 1 and Ubirajara Barroso Jr. ![]()
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