Dysfunctional voiding (DV) remains a poorly understood and a poorly managed problem, both in children and adults. The Think Tank (TT) discussed how to improve the management of DV in these two different age groups and in transitional care.
During the 2018 International Consultation on Incontinence Research Society held in Bristol, a multidisciplinary TT on DV was created. The presentations and subsequent discussion, leading to research recommendations intended to improve the management of DV in children and adults are summarized.
To improve the management of DV in children and adults, the TT panel proposed: (1) to conduct reliable prevalence studies of DV; (2) to perform longitudinal studies to prospectively test the sequence hypothesis by answering the following questions: (a) Which, if any children show a progression from overactive bladder or voiding postponement to DV?; (b) Which children develop each disorder without precursors?; and (c) Is there a continuation of DV from childhood to adulthood, or are adult cases new-onset presentations?; (3) to obtain detailed information regarding psychopathology to understand which comorbid psychological disorders prevail and at which rate, in those suffering DV; (4) to develop and validate diagnostic tools specifically for DV; (5) to better establish urodynamic correlates of DV specific for different age groups; and (6) to generate prospective long-term data regarding the efficacy of different treatment options and management strategies.
The future research recommendations of this TT may improve our management of DV in children and adults.
Neurourology and urodynamics. 2019 Dec [Epub]
Tufan Tarcan, Alexander von Gontard, Apostolos Apostolidis, Giovanni Mosiello, Paul Abrams
Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey., Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany., Second Department of Urology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., Department of Surgery, Neuro-Urology Unit, Bambino Gesu Pediatric Hospital, Rome, Italy., Bristol Urological Institute, Southmead Hospital, Bristol, UK.