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The first 25 slides, exactly as they appear. The full deck has 55 content slides.
Paediatric Surgery
Daytime Urinary Incontinence
Built from Puri — Pediatric Surgery and Pediatric Urology
What’s inside
8 sections · 55 slides
Overview
- What this deck will teach you
Foundations
What daytime wetting is, and the words we use for it
- Start here: the child who wets during the day
- Two families of leakage: continuous vs intermittent
- Urgency, detrusor overactivity, and overactive bladder
- Four more terms worth pinning down early
How Common, and the Company It Keeps
Prevalence and the conditions that travel with it
- Daytime incontinence by the numbers
- How common it is, and how it changes with age
- Bed-wetting and constipation: the constant companions
- The behavioural and self-esteem connection
- Infection and reflux: association, not always cause
Why the Bladder Misbehaves
Mechanisms behind urge incontinence
- A multifactorial and still-mysterious cause
- The 'immature bladder' idea
- The nerves and chemical messengers involved
- The bowel next door: how constipation drives wetting
- The rare but serious structural causes to keep in mind
Evaluation
How to work up a wetting child with almost no tests
- Why we evaluate at all: two goals
- Warning signs that demand a closer look
- The case history: the most valuable tool you have
- The history keeps going: bowel, behaviour, and health
- The physical examination: quick but revealing
- The bladder diary: cheap, powerful, and therapeutic
- Expected bladder capacity formula
- Reading the diary against expected bladder capacity
- Blood and urine tests: only when indicated
- Non-invasive urodynamics: uroflow plus residual urine
- When to do the extra tests
- Radiology: use it sparingly and for a reason
First-Line Treatment
Retrain the bladder, clear the bowel, then medicate
- Who should we treat, and why?
- The treatment ladder in overview
- Treatment pathway for urge incontinence
- Urotherapy: retraining the bladder without drugs
- Treat the constipation, or the bladder won't behave
- Anticholinergics: calming the overactive muscle
- Dosing and follow-up of anticholinergics
Special Situations
Bacteriuria, vaginal reflux, giggle and stress incontinence
- Asymptomatic bacteriuria: the innocent bystander
- Two easily-fixed girls' problems
- Stress incontinence: rare in children
Second-Line Treatment
Options when first-line therapy fails
- First, do not give up too early
- Newer drugs: alpha-blockers and mirabegron
- Invasive options: stimulation and botulinum toxin
- Conclusion and future directions
- Three things to remember
- References (1/4)
- References (2/4)
- References (3/4)
- References (4/4)
- Pediatric Surgery and Pediatric Urology