Dysfunctional elimination syndrome: a short review of the literature

Journal title

Folia Medica Cracoviensia




Vol. 61


No 2


Gkalonaki, Ioanna : First Department of Pediatric Surgery, Aristotle University of Thessaloniki Greece, General Hospital “G.Gennimatas”, Thessaloniki, Greece ; Patoulias, Ioannis : First Department of Pediatric Surgery, Aristotle University of Thessaloniki Greece, General Hospital “G.Gennimatas”, Thessaloniki, Greece



dysfunctional elimination syndrome ; functional voiding disturbances ; functional constipation ; urinary tract infection ; vesicoureteric reflux

Divisions of PAS

Nauki Medyczne




Oddział PAN w Krakowie; Uniwersytet Jagielloński – Collegium Medicum


1. Shaikh N., Hoberman A., Wise B., et al.: Dysfunctional elimination syndrome: is it related to urinary tract infection or vesicoureteral reflux diagnosed early in life? Pediatrics. 2003 Nov; 112 (5): 1134–1137.
2. Halachmi S., Farhat W.A.: Interactions of constipation, dysfunctional elimination syndrome, and vesicoureteral reflux. Adv Urol. 2008; 2008: 828275.
3. Aydoğdu O., Burgu B., Teber S., et al.: A challenging review of childhood incontinence: rare complications of dysfunctional elimination syndrome in an epileptic boy. Turk J Pediatr. 2011 Jan– Feb; 53 (1): 100–103.
4. Von Gontard A., Hollmann E.: Comorbidity of functional urinary incontinence and encopresis: somatic and behavioral associations. J Urol. 2004 Jun; 171 (6 Pt 2): 2644–2647.
5. Curran M.J., Kaefer M., Peters C., Logigian E., Bauer S.B.: The overactive bladder in childhood: long- term results with conservative management. J Urol. 2000 Feb; 163 (2): 574–577.
6. Hadjizadeh N., Motamed F., Abdollahzade S., Rafiei S.: Association of voiding dysfunction with functional constipation. Indian Pediatr. 2009 Dec; 46 (12): 1093–1095. Epub 2009 Apr 1.
7. Klijn A.J., Asselman M., Vijverberg M.A., et al.: The diameter of the rectum on ultrasonography as a diagnostic tool for constipation in children with dysfunctional voiding. J Urol. 2004 Nov; 172 (5 Pt 1): 1986–1988.
8. Wein A.J., Kavoussi L.R., Campbell M.F.: Urology Cambell-Walsh, 10th ed. Saunders Elsevier: 2012; 3418–3420.
9. O’Regan S., Yazbeck S.: Constipation: a cause of enuresis, urinary tract infection and vesico-ureteral reflux in children. Med Hypotheses. 1985 Aug; 17 (4): 409–413.
10. O’Regan S., Yazbeck S., Schick E.: Constipation, bladder instability, urinary tract infection syndrome. Clin Nephrol. 1985 Mar; 23 (3): 152–154.
11. Ab E., Schoemaker M., Van Empelen R.: Paradoxical movement of the pelvic floor in dysfunctional voiding and the results of biofeedback training. Br J Urol Int. 2002; 89: 48.
12. Patoulias I.: Voiding disturbance in childhood. 1st ed. Parisianos, Athens: 2011; 58– 59. ISBN 978- 960-394-723-3.
13. Loening-Baucke V.: Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood. Pediatrics. 1997 Aug; 100 (2 Pt 1): 228–232.
14. Chase J., Austin P., Hoebeke P., McKenna P.: International Children's Continence Society. The management of dysfunctional voiding in children: a report from the Standardisation Committee of the International Children’s Continence Society. J Urol. 2010 Apr; 183 (4): 1296–1302.
15. Hoebeke P., Van Laecke E., Van Camp C., Raes A., Van De Walle J.: One thousand video-urodynamic studies in children with non-neurogenic bladder sphincter dysfunction. BJU Int. 2001 Apr; 87 (6): 575–580.
16. Herndon C.D., Decambre M., McKenna P.H.: Interactive computer games for treatment of pelvic floor dysfunction. J Urol. 2001 Nov; 166 (5): 1893–1898.
17. Hansson S., Hjalmas K., Jodal U., Sixt R.: Lower urinary tract dysfunction in girls with untreated asymptomatic or cover bacteriuria. J Urol. 1990; 143: 333–336.
18. Issenman R.M., Filmer R.B., Gorski P.A.: A review of bowel and bladder control development in children: how gastrointestinal and urologic conditions relate to problems in toilet training. Pediatrics 1999; 103: 1346–1352.
19. Regan S.O., Schick E., Hamburger B., Yazbeck S.: Constipation associated with vesicoureteral reflux. Urol. 1986; 28: 394–396.
20. Chen J.J., Mao W., Homayoon K., Steinhardt G.F.: A multivariate analysis of dysfunction elimination syndrome, and its relationships with gender, urinary tract infection and vesicoureteral reflux in children. J Urol. 2004; 171: 1907–1910.
21. Naseer S.R., Steinhardt G.F.: New renal scars in children with urinary tract infections, vesicoureteral reflux and voiding dysfunction: a prospective evaluation. J Urol. 1997 Aug; 158 (2): 566–568.
22. Mulders M.M., Cobussen-Boekhorst H., de Gier R.P., Feitz W.F., Kortmann B.B.: Urotherapy in children: quantitative measurements of daytime urinary incontinence before and after treatment according to the new definitions of the International Children’s Continence Society. J Pediatr Urol. 2011 Apr; 7 (2): 213–218.
23. Nevéus T., Von Gontard A., Hoebeke P., et al.: The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children’s Continence Society. J Urol. 2006 Jul; 176 (1): 314–324.
24. Farhat W., Bägli D.J., Capolicchio G., et al.: The dysfunctional voiding scoring system: quantitative standardization of dysfunctional voiding symptoms in children. J Urol. 2000 Sep; 164 (3 Pt 2): 1011–1015.
25. Bower W.F., Yip S.K., Yeung C.K.: Dysfunctional elimination symptoms in childhood and adulthood. J Urol. 2005 Oct; 174 (4 Pt 2): 1623–1627; discussion 1627–1628.
26. Vereecken R.L., Proesmans W.: Urethral instability as an important element of dysfunctional voiding. J Urol. 2000; 163: 585–588.
27. Dede O., Sakellaris G.: Daytime urinary incontinence. Essentials in Pediatr Urol. 2012; 57–68.
28. Desantis D.J., Leonard M.P., Preston M.A., Barrowman N.J., Guerra L.A.: Effectiveness of biofeedback for dysfunctional elimination syndrome in pediatrics: a systematic review. J Pediatr Urol. 2011 Jun; 7 (3): 342–348.
29. Dyer L.L., Franco I.: Botulinum Toxin-A Therapy in pediatric Urology: Indications for the Neurogenic and Non-Neurogenic Neurogenic Bladder. Scientific World J. 2009; 9: 1300–1305.
30. Kroll P., Jankowski A., Soltysiak J., et al.: Botulinum toxin-A injections in children with neurogenic bladder. Nephroourol. 2011; 3: 125–128.
31. Carr L.K.: Botulinum toxin A should not be first-line therapy for overactive bladder. Can Urol Assoc J. 2011 Jun; 5 (3): 204–205.
32. Steele S.S.: Botulinum toxin A: First-line therapy for idiopathic detrusor over activity. Can Urol Assoc J. 2011; 5: 207–209.
33. Barroso U. Jr, Tourinho R., Lordêlo P., Hoebeke P., Chase J.: Electrical stimulation for lower urinary tract dysfunction in children: a systematic review of the literature. Neurourol Urodyn. 2011 Nov; 30 (8): 1429–1436.
34. Lordêlo P., Soares P.V., Maciel I., Macedo A. Jr, Barroso U. Jr.: Prospective study of transcutaneous parasacral electrical stimulation for overactive bladder in children: long-term results. J Urol. 2009 Dec; 182 (6): 2900–2904.






DOI: 10.24425/fmc.2021.137225