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Bladder and Bowel Dysfunction, Pediatric

Kara N. Saperston, MD and Laurence S. Baskin, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Bladder and bowel dysfunction (BBD) is the appropriate term that the International Children’s Continence Society has agreed upon to define combined bowel and bladder disturbance.

  • Chil...

DIAGNOSIS

HISTORY

  • A child will present after toilet training with symptoms of daytime and/or nighttime incontinence.

  • In addition, he or she may have a history of recurrent UTIs or VUR.

  • Bowel dysfunction ...

TREATMENT

GENERAL MEASURES

Behavior modification 
  • Educate proper voiding mechanics.

  • Timed voiding every 2 hours; may use a watch with a repeating alarm

  • Correct sitting and standing positions during voidin...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Patients need follow-up around 1 month after commencing treatment of the constipation, at that point, improvement in the LUTS becomes evident. T...

ADDITIONAL READING

  • Austin P, Bauer S, Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee o...

CODES

ICD9

  • 788.30 Urinary incontinence, unspecified

  • 564.00 Constipation, unspecified

  • 787.60 Full incontinence of feces

ICD10

  • R32 Unspecified urinary incontinence

  • K59.00 Constipation, unspecified

  • R15.9 Full i...

FAQ

  • Q: Should children with BBD have urodynamic evaluation?

  • A: Rarely. A patient should undergo standard therapy with timed voiding and treatment of constipation as the 1st-line therapy. If that fails,...

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