URINARY-INCONTINENCE AND URINARY-TRACT INFECTION AND THEIR RESOLUTIONWITH TREATMENT OF CHRONIC CONSTIPATION OF CHILDHOOD

Objectives. To evaluate the frequency of urinary incontinence and urin ary tract infection in children with chronic constipation and report o n the resolution of these with treatment of the underlying constipatio n. Methods. We evaluated the frequency of urinary incontinence and uri nary tract infection in 234 chronic constipated and encopretic childre n before, and at least 12 months after, the start of treatment for con stipation. Results. Twenty-nine percent complained of daytime urinary incontinence and 34% of nighttime urinary incontinence. Urinary tract infection was present in 11% and was more commonly present in girls th an in boys (33% vs 3%). Vesicoureteral reflux was present in four and megacystis in four of the 25 children who had a voiding cystourethrogr am because of urinary tract infection. One girl who came in had consti pation and acute urinary retention. The treatment for constipation con sisted of disimpaction and maintenance treatment, which included the p revention of reaccumulation of stools and reconditioning to normal bow el habits through timed toilet sitting. Follow-up, at least 12 months after start of treatment for constipation, revealed that the constipat ion was relieved successfully in 52%. Relief of constipation resulted in disappearance of daytime urinary incontinence in 89% and nighttime urinary incontinence in 63% of patients, and disappearance of recurren t urinary tract infections in all patients who had no anatomic abnorma lity of the urinary tract. Conclusion. Urinary symptoms were found in a significant number of children who had functional constipation and e ncopresis. With treatment of the constipation, most patients became cl ean and dry and further recurrence of urinary tract infections was pre vented.