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Assessment of non‐neurogenic incontinence and lower urinary tract symptoms in adolescents and young adults
Author(s) -
Bower W.F.,
Swithinbank L.,
de Jong T.,
de Kort L.M.O.,
MarschallKehrel D.
Publication year - 2010
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.20829
Subject(s) - medicine , urinary incontinence , lower urinary tract symptoms , urinary system , urology , gynecology , prostate , cancer
Aims The aim of this article is to provide insight to clinicians who principally treat adults, about non‐neurogenic lower urinary tract symptoms (LUTS) either pre‐dating or presenting in adolescence. Assessment fundamentals, diagnostic classification, and rationale behind the process of care are discussed. Methods Standardized terms are used to describe the current classification of symptoms of LUT dysfunction in young adults. The etiology and symptomatology of continuous and organic incontinence, along with the intermittent presentations of incontinence, nocturnal enuresis, and bowel dysfunction are presented. Minimally acceptable assessment processes are defined. Indications for the inclusion of urodynamic investigations are presented. Throughout the review specific needs of adolescents, as they apply to clinical management of LUTS, are highlighted. Results Puberty and growth are likely to challenge compensatory mechanisms for a safe urinary system in young adults with organic/structural/developmental LUT disorders. The priority of care is to screen for and detect precursor signs of renal deterioration. In adolescents with non‐neurogenic bladder dysfunction a clear diagnosis and identification of both incomplete bladder emptying and high detrusor pressure will minimize permanent changes to both the upper and lower urinary tracts. Conclusions The assessment of adolescents with LUTS requires time, thoughtful enquiry, and communication. Dysfunction pre‐dating young adulthood commonly inhibits autonomy, recreational and social activities thus impacting on the adolescent's self‐esteem and adherence to treatment regimes. Neurourol. Urodynam. 29:702–709, 2010. © 2010 Wiley‐Liss, Inc.