Bladder function and non-neurogenic dysfunction in children: classification and terminology.

Urological function and dysfunction in children are different from function and dysfunction in adults. The dynamics of the urinary tract in children are more complex as development from simple reflex controlled infant bladder to mature bladder function takes place during the first five years of live. The most crucial event in this development is the maturation of the inhibition that takes place in the growing urinary tract. Apart from gaining neurological control over de lower urinary tract there is the physical growth of the bladder-sfincter unit. Otherwise in children there exist a large amount of structural organic congenital pathology of the lower urinary tract that can trouble the normal development. Finally there is the cognitive function that has no anatomical substrate in the lower urinary tract but which takes place in the central nervous system and which is influenced by training and which can play a major role in development of non structural functional dysfunction. In order to train a child adequately the anatomical structure needs to have undergone enough maturation. By training a child on a too early age one can help to develop non structural functional dysfunction. In a time where competition in dry-training is encouraged by commercial pressure and where parents have less time, so that they are urged to train their children dry, more and more non-structural functional dysfunction in children is seen. The most prominent symptom of maldevelopment of the urinary tract, be it structural or functional is urinary incontinence. It is the most common problem seen in the paediatric urology practice.(ABSTRACT TRUNCATED AT 250 WORDS)