Pediatric urinary incontinence: Classification, evaluation, and management

Abstract

Objective: To review the classification, evaluation, and management of pediatric urinary incontinence.
Methods: An examination of texts and peer-reviewed literature was performed to identify subject matter relevant to the stated objectives, with the experience of the senior author used in cases where the literature failed to provide guidance.
Results: On the basis of our review, we identified the International Children’s Continence Society’s (ICCS) statement standardizing the terminology for lower urinary tract function in children and present a logical classification scheme for incontinence. After an epidemiology review, we discuss the appropriate evaluation of the incontinent child, of which the cornerstones are a detailed history and thorough physical exam. Finally, a concise discussion of the management of daytime incontinence, nocturnal enuresis, and neurogenic and anatomic incontinence is presented, with deference to evidence-based approaches where available. Depending on the type of incontinence, the management strategies can include behavioral, pharmacologic, and/or surgical approaches.
Conclusion: Pediatric urinary incontinence is a common condition which, after appropriate evaluation, can be successfully treated.

Keywords: Urinary incontinence; Diurnal enuresis; Nocturnal enuresis; Pediatrics