An Overview of Treatment in Pediatric Bladder-Bowel Dysfunction: A single-centre experience

Objective: This study aimed to evaluate the clinical characteristics, treatment responses, and outcomes of pediatric patients diagnosed with bladder-bowel dysfunction, highlighting a structured management approach including urotherapy, pharmacotherapy, and rehabilitation techniques. Method: A retrospective study was conducted with 1846 children aged 5-18 years diagnosed with bladder-bowel dysfunction at Bakırçay University Çiğli Training and Research Hospital between 2022 and 2025. Patients with neurological disorders were excluded. Data on demographics, bladder-bowel symptom scores, treatment modalities, uroflowmetry results, and treatment outcomes were collected. Conservative treatments included use of osmotic-laxatives and urotherapy. Patients unresponsive to initial therapies received treatment with antimuscarinics, biofeedback, and transcutaneous electrical nerve stimulation where appropriate. Results: The mean age of the patients was 104.4 months. Female predominance (67%) was observed. Conservative management alone successfully resolved symptoms in 512 patients without vesicoureteral reflux or recurrent urinary tract infections. Patients with higher bladder-bowel symptom scores (>20) and pathological uroflowmetry results required biofeedback and, in some cases, transcutaneous electrical nerve stimulation. No relapse was observed in any subgroup of patients during the 6-month follow-up period. Effective management of constipation and lifestyle modifications were critical for treatment success. Conclusion: A stepwise treatment protocol focusing on bowel regulation, urotherapy, and individualized interventions provides effective symptom control and prevents disease progression in pediatric bladder-bowel dysfunction. Early diagnosis, attention to modifiable risk factors such as constipation, and long-term adherence to behavioral strategies are essential for optimal treatment outcomes. Prospective studies with extended follow-up periods are warranted.