Management of Disorders of Bladder and Bowel Control in Childhood

Elimination disorders (nocturnal enuresis, urinary incontinence and encopresis) are among the most common disorders of childhood. Some disorders are primarily genetically determined, in others environmental factors predominate. Also, the rate of comorbid behavioural disturbances differs greatly from one syndrome to another. Because of this variety and heterogeneity, each disorder requires specific approaches in assessment and treatment. This book provides an evidence-based overview of functional elimination disorders. It draws on the standardisation and terminology suggested by the International Children’s Continence Society. Short case vignettes, photos and line drawings, as well as questionnaires and charts are provided. To enable a quick orientation for clinical purposes, each chapter is followed by summaries, guidelines and diagrams. It will be of interest to all professionals working in the field.

Clinics in Developmental Medicine No. 170

AUTHORS’ APPOINTMENTS vii

PREFACE ix

LIST OF ABBREVIATIONS xi

1. INTRODUCTION 1

2. CLASSIFICATION AND DEFINITIONS 3

3. NORMAL BLADDER AND BOWEL DEVELOPMENT 10

4. GENERAL PRINCIPLES: ASSESSMENT 17

5. GENERAL PRINCIPLES: TREATMENT 65

6. NOCTURNAL ENURESIS 86

7. FUNCTIONAL URINARY INCONTINENCE 131

8. ORGANIC URINARY INCONTINENCE 185

9. FUNCTIONAL FAECAL INCONTINENCE (ENCOPRESIS) 214

10. ORGANIC FAECAL INCONTINENCE 273

11. CONCLUSION 278

APPENDICES 279

REFERENCES 310

INDEX 343