Abstract

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.

Materials and Methods

A retrospective study was conducted of 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 outcomes were collected. Conservative treatments included osmoticlaxatives and urotherapy. Patients unresponsive to initial therapies received antimuscarinics, biofeedback, and transcutaneous electrical nerve stimulation where appropriate.

Results

The mean age was 104.4 months. Female predominance was observed (67%). Conservative management alone successfully resolved symptoms in 512 patients without vesicoureteral reflux or recurrent urinary tract infections. Patients with higher bladder-bowel symptom score (>20) and pathological uroflowmetry required biofeedback and, in some cases, transcutaneous electrical nerve stimulation. No relapse was observed in any subgroup during the 6-month follow-up. Effective constipation management 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 outcomes. Prospective studies with extended follow-up are warranted.