Cargando…

Preserved Voluntary Micturition Control despite Early Urinary Diversion in Infancy—A Clue to a New Strategy

Micturition is an involuntary process based on spinal arcs in infants and children until a defined age. The awareness and voluntary control of voiding depends on specific areas in the central nervous system, especially cortical regions. The cells and connections between these areas develop over time...

Descripción completa

Detalles Bibliográficos
Autores principales: Borselle, Dominika, Patkowski, Dariusz, Kiliś-Pstrusińska, Katarzyna, Apoznański, Wojciech
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9140153/
https://www.ncbi.nlm.nih.gov/pubmed/35626777
http://dx.doi.org/10.3390/children9050600
_version_ 1784715029638021120
author Borselle, Dominika
Patkowski, Dariusz
Kiliś-Pstrusińska, Katarzyna
Apoznański, Wojciech
author_facet Borselle, Dominika
Patkowski, Dariusz
Kiliś-Pstrusińska, Katarzyna
Apoznański, Wojciech
author_sort Borselle, Dominika
collection PubMed
description Micturition is an involuntary process based on spinal arcs in infants and children until a defined age. The awareness and voluntary control of voiding depends on specific areas in the central nervous system, especially cortical regions. The cells and connections between these areas develop over time and regulate the voiding process. The ability to maintain continence and to adjust physiological needs to appropriate environmental conditions is considered to be acquired through systematic behavioral education, especially toilet training. The recommendations specify the age at which to start establishing the relevant habits. The purpose of these guidelines is to achieve proper micturition control development and to avoid functional lower urinary tract (LUT) disorders. We present a case of a patient who underwent complete urinary diversion in infancy and reconstruction of the urinary tract eleven years later. For eleven years, she had an empty bladder and no toilet training. After undiversion, she regained full continence in a short space of time. The presence of proper LUT function and a controlled micturition process raises the question of the standard toilet training recommendations’ validity. The aim of our work focuses on the following question: Is toilet training the only way to achieve micturition skills and proper urinary tract function? The history of our patient and the literature reveal that voluntary micturition may develop without stimulating signals of filling from bladder receptors and independently of recommended behavioral education, so toilet training seems to not be necessary.
format Online
Article
Text
id pubmed-9140153
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-91401532022-05-28 Preserved Voluntary Micturition Control despite Early Urinary Diversion in Infancy—A Clue to a New Strategy Borselle, Dominika Patkowski, Dariusz Kiliś-Pstrusińska, Katarzyna Apoznański, Wojciech Children (Basel) Case Report Micturition is an involuntary process based on spinal arcs in infants and children until a defined age. The awareness and voluntary control of voiding depends on specific areas in the central nervous system, especially cortical regions. The cells and connections between these areas develop over time and regulate the voiding process. The ability to maintain continence and to adjust physiological needs to appropriate environmental conditions is considered to be acquired through systematic behavioral education, especially toilet training. The recommendations specify the age at which to start establishing the relevant habits. The purpose of these guidelines is to achieve proper micturition control development and to avoid functional lower urinary tract (LUT) disorders. We present a case of a patient who underwent complete urinary diversion in infancy and reconstruction of the urinary tract eleven years later. For eleven years, she had an empty bladder and no toilet training. After undiversion, she regained full continence in a short space of time. The presence of proper LUT function and a controlled micturition process raises the question of the standard toilet training recommendations’ validity. The aim of our work focuses on the following question: Is toilet training the only way to achieve micturition skills and proper urinary tract function? The history of our patient and the literature reveal that voluntary micturition may develop without stimulating signals of filling from bladder receptors and independently of recommended behavioral education, so toilet training seems to not be necessary. MDPI 2022-04-23 /pmc/articles/PMC9140153/ /pubmed/35626777 http://dx.doi.org/10.3390/children9050600 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Borselle, Dominika
Patkowski, Dariusz
Kiliś-Pstrusińska, Katarzyna
Apoznański, Wojciech
Preserved Voluntary Micturition Control despite Early Urinary Diversion in Infancy—A Clue to a New Strategy
title Preserved Voluntary Micturition Control despite Early Urinary Diversion in Infancy—A Clue to a New Strategy
title_full Preserved Voluntary Micturition Control despite Early Urinary Diversion in Infancy—A Clue to a New Strategy
title_fullStr Preserved Voluntary Micturition Control despite Early Urinary Diversion in Infancy—A Clue to a New Strategy
title_full_unstemmed Preserved Voluntary Micturition Control despite Early Urinary Diversion in Infancy—A Clue to a New Strategy
title_short Preserved Voluntary Micturition Control despite Early Urinary Diversion in Infancy—A Clue to a New Strategy
title_sort preserved voluntary micturition control despite early urinary diversion in infancy—a clue to a new strategy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9140153/
https://www.ncbi.nlm.nih.gov/pubmed/35626777
http://dx.doi.org/10.3390/children9050600
work_keys_str_mv AT borselledominika preservedvoluntarymicturitioncontroldespiteearlyurinarydiversionininfancyacluetoanewstrategy
AT patkowskidariusz preservedvoluntarymicturitioncontroldespiteearlyurinarydiversionininfancyacluetoanewstrategy
AT kilispstrusinskakatarzyna preservedvoluntarymicturitioncontroldespiteearlyurinarydiversionininfancyacluetoanewstrategy
AT apoznanskiwojciech preservedvoluntarymicturitioncontroldespiteearlyurinarydiversionininfancyacluetoanewstrategy