MANAGEMENT OF THE INCONTINENT CHILD IN GENERAL-PRACTICE - THE PEDIATRIC UROLOGISTS VIEWPOINT

Except for children with neurological disease or major structural anomalies, the burden of managing childhood urinary incontinence in the UK falls predominantly upon general practitioners and local specialists. Because they see relatively few cases and have many other calls upon their attention, their postgraduate education on this topic must be succinct and basic; this article is based upon such advice. The organic causes of childhood urinary incontinence are discussed as also the clinical features and basic investigations (principally ultrasonography) which call attention to them. The various clinically recognisable patterns of functional voiding disorders are described with emphasis on the commonest, urge incontinence. Based on these considerations a scheme is recommended which aims to minimise necessity for secondary or tertiary referral, yet at the same time ensures that organic disease or severe functional voiding disorders are not overlooked.