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Children with urinary incontinence and no anatomic or neurological abnormalities may need a urodynamic study if simpler methods of treatment, including a combination of drugs to help achieve dryness and behavioral modification strategies, fail to correct the problem.
For children with recurring urinary infection, urodynamics studies are usually performed after the child has been on continued long-term antibiotics, but is still having episodes of incontinence or recurring infection. The study may also be necessary when X-ray imaging reveals particular abnormalities of the bladder in children who have had multiple urinary infections.
For children with obvious neurological conditions, such as myelodysplasia, the studies are usually performed during the newborn period, to help your baby's pediatric urologist initiate therapy to prevent symptoms of the condition. The doctors will also want to use the test to assess the baby's neurological status because, as the child grows, there may be progressive changes in the neurological function of the bladder stemming from the spinal cord. As a result, if there are concerns over the spinal cord, the studies are usually repeated periodically. Studies are also needed when these children are older, if they haven't achieved continence with simple measures of intermittent catheterization and drugs that help paralyze the bladder.
Studies may also be performed when imaging studies reveal changes in the appearance of the upper urinary tract, which suggests an alteration in bladder function. In children with other anatomic conditions that lead to incontinence, such as bladder exstrophy/epispadias or anorectal malformations, urodynamics studies are necessary as soon as the diagnosis is made and after initial treatments fail to correct the incontinence. Testing helps guide the pediatric urologist toward other means of therapy and improves the efficiency of your child's treatment plan.
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