When I evaluate a child with daytime incontinence, parents frequently comment that their child never seems to know when to urinate until he/she has had an accident. The role of abnormal sensation in children with incontinence has not been focused on nearly as much as other factors. This is partly because of its subjective nature as well as the lack of reliable methods to measure it. This manuscript focuses on a noninvasive technique to objectively measure the bladder's sensory function. By measuring the time to sensation rather than the volume, more than 1 measurement can be made (ie, normal desire and strong desire) without the child needing to void. The patients were hydrated by protocol to try creating a relatively constant rate of urine production. To further eliminate the effect of variable rates of urine production, the ratio of time of normal desire to strong desire was calculated. The results showed that these noninvasive measurements were reproducible over 3 days with good correlation. In comparison with volumes when the sensations occurred during cystometry, the noninvasive measurements did not correlate well. Although this indicates that the time measurements cannot be substituted for sensations reported during cystometry, they could possibly be a better indicator of bladder sensory function because of the lack of the influence of the urethral catheter.
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