AUA2021 Panel Discussion: Pediatric Bladder Dysfunction

By: Christopher S. Cooper, MD; Presenters: Seth Alpert, MD; Stacy Tanaka, MD, MS; Israel Franco, MD | Posted on: 03 Sep 2021

I am honored to moderate a 20-minute panel session at the American Urological Association’s 2021 Annual Meeting entitled, “Second Opinion Cases: Pediatric Bladder Dysfunction.” This session will include 3 brief but rather unique case presentations with an emphasis on take-home points that are applicable to both general and pediatric urologists.

The panel consists of 3 outstanding experts in pediatric bladder dysfunction: Seth Alpert, MD, is a pediatric urologist at Nationwide Children’s Hospital and Clinical Associate Professor of Urology at The Ohio State University College of Medicine; Stacy Tanaka, MD, MS, is a pediatric urologist at Monroe Carell Jr. Children’s Hospital, Director of the Spina Bifida Clinic and Professor of Urology at Vanderbilt University Medical Center; and Israel Franco, MD, is Professor of Clinical Urology and Director of Yale Medicine Pediatric Bladder and Continence Program.

Pediatric bladder dysfunction is common and constitutes up to 40% of pediatric urology clinic visits. It is also a condition frequently seen and treated by general urologists.1 The most typical manifestations of pediatric bladder dysfunction include incontinence as well as urgency, frequency and recurrent UTIs. Pediatric bladder dysfunction is often associated with bowel dysfunction. Over the last several decades, urologists have become very familiar with the need to aggressively treat undiagnosed constipation, which often results in improved bladder function and urinary symptoms as well as a reduction in UTIs.2 Additionally, the utility of timed voiding is well known by urologists and is routinely recommended as initial management for common urinary complaints, obviating the need for medications in many children.3

The focus of this session will be to review some atypical presentations of pediatric bladder dysfunction. All of the patients described in these case presentations were refractory to the standard treatment methods and had been referred to one of our expert panelists. Atypical symptoms include pain as well as stress incontinence and severe lower urinary tract symptoms despite maximal medical management. These cases will not only demonstrate the need for urologists to consider bladder dysfunction as the potential cause of these atypical presentations but also will cover the pathophysiology causing the symptoms and describe the successful management methods employed by each of our panelists.

We anticipate that the session will be engaging, educational and provide each audience member with at least several new “take-home” points for their own practices. For these reasons, we hope to see each of you in attendance at this plenary session, Sunday morning, September 12.

  1. Nepple KG and Cooper CS: Management of bladder dysfunction in children. UpToDate 2021. Available at https://www.uptodate.com/contents/management-of-bladder-dysfunction-in-children.
  2. Erickson BA, Austin JC, Cooper CS et al: Polyethylene glycol 3,350 for constipation in children with dysfunctional elimination. J Urol 2003; 170: 1518.
  3. Allen HA, Austin JC, Boyt MA et al: Initial trial of timed voiding is warranted for all children with daytime incontinence. Urology 2007; 69: 962.
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