| A child with urinary incontinence from birth
A male child aged 8 years presented to hospital with a history of constantly leaking urine. The child had never gained continence. The urine loss was a constant dribble, worsened whenever the child stood up, strained, or cried. There was no faecal soiling, and the child had been passing two to three formed stools daily. Developmental milestones were normal, as were intellectual milestones. On examination, the child's mentation was found to be normal. There was no neurological deficit. Abdomen was soft, with no palpable organs or masses. The genitalia were well developed, and normal. Anal sphincter tone was normal, as were the anal and Bulbocavernosus reflexes. There was a constant dribble of urine, and suprapubic pressure produced only a small spurt of urine. Urine examination was normal. Renal functions were normal. Sonography showed normal kidneys, with no hydronephrosis. The urinary bladder wall was normal, and the bladder held only 10 ml of urine. The bladder would nor fill further.
What needs to be done, next? Kindly post your responses to the webmaster and the editorial board will discuss the responses and the management plan in due course.
|