2016 23(11):952–6.īauer SB, Nijman RJ, Drzewiecki BA, Sillen U, Hoebeke P. Direct influence of systemic desensitization by resiniferatoxin on the activities of Aδ- and C-fibers in the rat primary bladder mechanosensitive afferent nerves. Further understanding of neural control and the associated neurotransmitters will help in the development of novel therapies in the future.Īizawa N, Fukuhara H, Fujimura T, Homma Y, Igawa Y. Important reviews of the neural control of the bladder. The central autonomic network and regulation of bladder function. Neural control of the lower urinary tract. 56–9.ĭe Groat WC, Griffiths D, Yoshimura N. Urodynamics in normal infants and children. Papers of particular interest, published recently, have been highlighted as: Further studies are needed to understand the neural circuits involved in voiding control and expand treatment options for voiding disorders. Current treatment strategies can yield over 90% response rate when instituted correctly. Individualized therapy includes education, behavioral interventions, pharmacotherapy, and use of devices. SummaryĬhildhood voiding disorders have complex pathophysiology and may contribute to comorbid conditions including VUR and UTIs. Treatment involves an individualized, patient-centric approach. To achieve voiding control, bowel elimination habits must be normalized and associated psychosocial problems must be addressed. Children with OAB are at risk of developing dysfunctional obstructed voiding, recurrent urinary tract infections (UTIs), secondary onset of vesicoureteral reflux (VUR), detrusor fibrosis, and upper tract damage. OAB and NE often result from delayed maturation or pathological alteration of central nervous system control over the lower urinary tract and may coexist with learning and psychosocial problems, attention deficit hyperactivity disorder (ADHD), and incomplete defecation. This review will inform the physiology of urine storage, bladder emptying, volitional control of voiding, pathogenesis, management of the most common voiding disorders in children, including overactive bladder (OAB)–induced diurnal urinary urgency and urge incontinence, nocturnal enuresis (NE), and dysfunctional voiding from functional detrusor-external sphincter dyssynergy.
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