6 Section 2 General Aspects This book uses the globally accepted ESPU-ICCS terminology 1-4 We briefly discuss terminology, the aspects of diagnostics, the role of the urotherapist and the rationale of treatment plans, below. 1. Functional Bowel and Bladder Dysfunction Bladder and Bowel Dysfunction (BBD) is an umbrella term that encompasses lower urinary tract dysfunction (LUTD) and bowel dysfunction. LUTD symptoms are classified according to their relation to the storage and/or voiding phase of bladder function. Lower urinary tract symptoms (LUTS) can manifest as urgency and frequency with or without incontinence, or recurrent UTI. The possible diagnoses in children with LUTS are overactive bladder, dysfunctional voiding, underactive bladder, voiding postponement, stress incontinence, giggle incontinence, vesicovaginal reflux incontinence and enuresis. There are several subtypes of daytime incontinence, (see table 1) which are classified according to their relation to the storage and/or voiding phase of bladder function. Risk factors for these subtypes of incontinence can be genetic, demographic, environmental, behavioural, and physical. Therefore, treatment is multidisciplinary, and an accurate diagnosis is required for the treatment to be successful. 1,2,4-8 Subtypes Symptoms Signs Overactive bladder Frequency Voiding urgency Incontinence Constipation Enuresis (Cystometric) detrusor overactivity Holding maneuvers Bell shape/ tower shape pattern Thick bladder wall Low volume voids
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