Urodynamics in children. Part II. The pseudoneurogenic bladder.

We evaluated 83 children for recurrent urinary infections, day and night urinary incontinence or both for more than 1 year in the urodynamic laboratory. Bladder instability and/or bladder sphincter dyssynergia was encountered in 74 children. Pharmacologic manipulation of detrusor and sphincter function and biofeedback therapy were highly successful. Routine and random urethral dilation, urethrotomy and fulguration, and/or resection of ill-defined urethral obstructions is unwarranted. Rational treatment requires individualization based upon an objective evaluation by thorough and careful urodynamic testing.