For children aged 4 to 6 years, repetitive postvoid residual (PVR) greater than 20 mL or greater than 10% bladder capacity (BC) can be regarded as elevated. For children aged 7 to 12 years, repetitive PVR greater than 10 mL or 6% BC can be defined as elevated.
Bladder outlet obstruction can be suspected in cases with a Qmax less than 11.5 mL/sec (patients aged 4 to 6 years) or less than 15.0 mL/sec (patients aged 7 to 12 years).
Low bladder compliance (less than 20 mL H2O) is frequently associated with neuropathic lower urinary tract dysfunction (LUTD) and may have detrimental effects on the upper tracts.
ICCS defines increased daytime urinary frequency as eight or more voids per day and decreased daytime urinary frequency as three or fewer voids per day.
The International Children's Continence Society (ICCS) views 6 years as the minimum age to adequately report lower urinary tract symptoms, and 5 years as the minimum age for functional bowel dysfunction.
Frequency-volume chart is necessary to document whether he has small voided volume throughout the day.
Uroflowmetry may disclose a staccato flow pattern suggesting dysfunctional voiding.
Anticholinergics will be the first-line treatment for him.
Postvoid residual urine may be normal or elevated.
Urinalysis should be done to exclude urinary tract infection.
Dysfunctional voiding is frequently observed in children after 1 year.
Dysfunctional voiding is characterized by an intermittent and/or fluctuating flow rate due to intermittent contractions of the periurethral striated or levator ani muscles during voiding in neurologically normal children.
Dysfunctional voiding is frequently associated with urinary tract infection (UTI), vesicoureteral reflux, and various types of LUTS.
Staccato, interrupted, plateau, and even normal flow patterns can be observed in children with dysfunctional voiding.
A uroflow with electromyogram (EMG) or a videourodynamic study is required to document dysfunctional voiding.
If image studies such as voiding cystography or videourodynamic study disclosed point stenosis at anterior urethra, an anterior urethral valve can be diagnosed.
None of the above.
If he had delayed bladder neck opening time (more than 4 seconds), he may have primary bladder neck dysfunction.
He may have congenital bladder outlet obstruction.
Because he had a plateau-shaped uroflowmetry curve, discoordinated sphincter is unlikely.
Abnormal voiding posture may be the cause of staccato flow pattern.
Fluid restriction and timed voiding may reverse this abnormal voiding pattern.
Bladder overdistention may be the cause of staccato flow pattern.
She may have dysfunctional voiding.
The predicted success rate of antireflux surgery is around 95%.
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