Lower Urinary Tract Terminology in Daytime Lower Urinary Tract Symptoms in Children: A View of the Pediatric Urologist

Context: Epidemiological studies have demonstrated rates of lower urinary tract (LUT) symptoms in school-aged children as high as 20%. Symptoms of LUT may have significant social consequences. The diagnosis of LUT symptoms in children is mainly based on the subjective impression, and it is therefore important to translate the clinical impression into a structured LUT terminology.

Objective: To have a view, as a pediatric urologist and a urologist, of the LUT terminology proposed by the Standardization Committee of the International Children Continence Society.

Evidence acquisition: In addition to the known LUT terminology conditions that are mainly functional, we propose to add specific urological malformations due to congenital or acquired urological conditions, leading to LUT symptoms.

Evidence synthesis: In addition to the opinion-based statements and practical clinical suggestions, we have added recent literature to support the statements and suggestions.

Conclusions: LUT symptoms in children can be from a functional or an anatomical origin. As the diagnosis is often made on the basis of subjective and variable information, experience of the medical caretaker is also important to allow categorization of the condition of the child into a well-structured LUT terminology. Medical caretakers should be aware of possible evidence-based diagnostic tools and be able to follow guidelines and algorithms to come to the correct diagnosis and condition of the child to allow one to distinguish functional from congenital or acquired anatomical LUT conditions.

Patient summary: Up to 20% of school-aged children can have wetting problems. Some wetting problems can be temporary, due to the young age, stress, psychological problems, or other associated problems such as bowel dysfunction. However, some wetting problems in children are due to a condition of the kidneys, bladder, or elsewhere in the urinary tract since they were born, and should be well investigated, as in most such situations the LUT problems could be treated surgically.