Disfungsi Kandung Kemih Non-Neurogenik pada Anak: Diagnosis dan Tata Laksana

Bladder dysfunction or lower urinary tract dysfunction is frequently found in children, which can be caused by neurologic, anatomical, or functional (non-neurogenic) problem. Urinary tract infection, vesicoureteral reflux, and renal scar are common secondary to bladder dysfunction, leading to chronic kidney disease and causing serious physical and psychosocial impact in childlhood. Clinical manifestation correlates well with the pathophysiology, either storage (filling) or voiding problem. Standard terms have been published by International Children’s Continence Society (ICCS) 2015. Diagnosis of bladder dysfunction could be clinically established by history taking and physical examination, focusing on excluding neurological or anatomical lesion and voiding diary. Further examination consists of non-invasive methods (urinalysis, ultrasonography, and uroflowmetry) or invasive methods (cystogram). Comprehensive management includes urotherapy (including biofeedback therapy), pharmacological treatment, urosurgery, and neuromodulation or neurostimulation.