⚡ Overactive Bladder · Diurnal Urge Syndrome

Nelson Textbook of Pediatrics 22nd Edition — Chapter 580 | Overactive bladder (urge syndrome): urinary frequency, urgency, urge incontinence. Associated with Vincent's curtsy (squatting), nocturnal enuresis in 25%. Treatment: timed voiding, anticholinergics (oxybutynin), biofeedback, constipation management.

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📋 30 Clinical Scenarios — Overactive Bladder (Diurnal Urge Syndrome)

📇 High‑Yield Review Cards (Overactive Bladder)

🩺 Clinical Recognition: Overactive Bladder

Select a presentation for diagnostic clues and management.

📋 Stepwise Management of Overactive Bladder

🔑 Key Principles — Overactive Bladder (Diurnal Urge Syndrome)
• Pathophysiology: Uninhibited detrusor contractions (bladder hyperreflexia) in absence of neurologic disease. Bladder is functionally smaller.
• Vincent's curtsy: Child squats on heel to prevent incontinence — classic sign.
• Associated conditions: 25% have nocturnal enuresis. Recurrent UTIs common (may be cause or effect). Spinning-top urethra on VCUG.
• First-line therapy: Timed voiding every 1.5-2 hours. Treat constipation aggressively.
• Pharmacotherapy: Oxybutynin (anticholinergic), tolterodine, solifenacin, mirabegron (beta-3 agonist).
• Biofeedback: Pelvic floor relaxation exercises, animated computer games, 8-10 sessions.
• Prognosis: Usually resolves, but may take years (occasionally until teenage years).

    ⚡ Reflex Prompts — Clinical Decisions in Overactive Bladder

    📖 Summary: Overactive Bladder (Diurnal Urge Syndrome) — Nelson Ch 580