PTU - Polskie Towarzystwo Urologiczne
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What do we know about bladder function in newborns and infants?
Article published in Urologia Polska 2007/60/1.


Lidia Skobejko-Włodarska
Klinika Urologii Dziecięcej, Instytut "Pomnik - Centrum Zdrowia Dziecka" w Warszawie


urinary bladder, normal function, newborns and infants, contemporary knowledge


The traditional concept of neonatal bladder function was revised during the past decade. Previously it had been believed that voiding was induced by a constant bladder volume, bladder emptying was complete and the whole process was not influenced by brain, and therefore was independent of sleep or consciousness or some other disturbing events [1,2,3]. The contemporary knowledge based on the results of urodynamic studies by Yeng, Wen and Bachelard and also 4-hour voiding observations of healthy newborns and infants, has completely changed previous notions [3-9]. It is currently known, that normal bladder function in healthy newborn or infant is characterized by frequent voidings (1 every hour) with varying volume, incomplete bladder emptying, dependence of incomplete emptying on physiological form of detrusor-sphincter dyscoordination, rare voiding during sleep, small bladder capacity during the first month of life, rare occurence of bladder overactivity in healthy infants, although premature voiding contraction with leakage of only a few millilitres of urine with saline occurs in neonatal period, which is a high reactivity of detrusor to stimulus as well as high level of maximum voiding pressure, especially in male infants [3-7].


  1. Muellner S: Development of urinary control in children. JAMA 1960, 172, 1256-1261.
  2. Klackenberg G: Expectations and reality concerning toilet-training. Acta Paediatr Scand 1971 Suppl, 224, 85.
  3. Sillen U, Hjalmas K: Bladder function in preterm and full-term Infants. Scand J Urol Nephrol 2004, Suppl 215, 63-68.
  4. Yeng CK, Godley ML, Ho CK: Some new insights into bladder function in infancy. Br J Urol 1995, 76, 235-240.
  5. Sillen U: Bladder function in healthy neonates and its development during infancy. J Urol 2001, 166, 2376-2381.
  6. Sillen U: Bladder function in infants. Scand J Urol Nephrol 2004, Suppl 215, 69-74.
  7. Holmdahl G, Hansson E, Hansson M et al: Four-hour voiding observation. J Urol 1996, 156, 1809-1812.
  8. Bachelard M, Sillen U, Hansson S et al: Urodynamic pattern in asymptomatic infants: siblings of children with vesicoureteral reflux. J Urol 1999, 162, 1733-1737.
  9. Wen JG, Tong EC: Cystometry in infants and children with no apparent voiding symptoms. Br J Urol 1998, 81, 468.
  10. Wertheimer J: L´hyptogenese de l´enuresis nocturne et de son traitement. Rev Franc Pediatr 1938, 14, 264.
  11. Duche DJ: Patterns of micturition on infancy. An introduction to the study of enuresis. In: Bladder Control and Enuresis, Edited by Kolvin I, Mac Keith RC, Meadow SR. Philadelphia, Lippincott 1973, chapt. 2: 23-27.
  12. Jansson UB, Hansson M, Hansson E: Voiding pattern in healthy children 0 to 3 years old: a longitudinal study. J Urol 2000, 164, 2050-2054.
  13. Sillen U, Solsnes E, Hellstrom AL, Sandberg K: The voiding pattern of healthy preterm neonates. J Urol 2000, 163, 278-281.
  14. Campbell S, Wladimiroff JW, Dewhurst CJ: The antenatal measurement of fetal urine production. J Obstet Gynecol 1973, 80, 680-686.
  15. Sillen U, Bachelard M, Hansson S et al: Video cystometric recording of dilating reflux in infancy. J Urol 1996, 155, 1711-1715.
  16. Podesta M, Castera R, Ruarte A: Videourodynamic findings in young infants with severe primary reflux. J Urol 2004, 171, 829-833.
  17. Sillen U, Hellstom AL., Holmdahl G, Solsnas F: The voiding pattern in infants with dilating reflux. BJU Int 1999, 83, 83-87.
  18. Holmdahl G, Hansson E, Hansson M et al: Four-hour voiding observation in small boys with posterior urethral valves. J Urol 1998, 160, 1477-1481.
  19. Zerin J, Chen E, Ritchy ML, Bloom DA: Bladder capacity as measured at voiding cystourethrography in children. Relationship to toilet training and frequency of micturition. Radiology 1993, 87, 803-806.
  20. Bakker E, Wyndaele JJ: Changes in the toilet training of children during the last 60 years: the cause of an increase in lower urinary tract dysfunction. BJU Int 2000, 86, 248-252.
  21. Brazelton T: A child oriented approach to toilet training. Pediatrics 1962, 29, 579-588.
  22. Sillen U, Holmdahl G, Hansson E et al: High overnight bladder volume is important for the development of over-distended bladder in small boys in PUV. BJU Int 2001, Suppl 87, 33.
  23. Holdmahl G, Sillen U, Bertilsson M: Natural fill cystometry in small boys with posterior urethral valves; unstable valve bladder becomes stable during sleep. J Urol 1997, 158, 1017-1021.
  24. Sillen U, Hellstrom AL, Solsnes E, Jansson UB: Control of voidings means better emptying of the bladder in children with congenital dilating vesicoureteral reflux. BJU Int 2000, Suppl 85, 13.
  25. Hjalmas K: Micturition in infants and children with normal lower urinary tract. Scand J Urol Nephrol 1976, Suppl 37, 1-106.
  26. Hjalmas K: Urodynamics in normal infants and children. Scand J Urol Nephrol 1988, 22, Suppl 114, 20.
  27. Bachelard M, Sillen U, Jodal U: Urodynamic pattern in infants with urinary tract infection. J Urol 1998, 160, 522.
  28. Sugaya K, de Groat WC: Influence of temperature on activity of the isolated whole bladder preparation of neonatal and adults rats. Am J Physiol 2000, 278, 238.
  29. Zedric S. A., Sillen U, Liu GH: Developmental aspects of bladder contractile function: evidence for an intracellular calcium pool. J Urol 1993, 150, 623.


Lidia Skobejko-Włodarska
Klinika Urologii Dziecięcej CZD
al. Dzieci Polskich 20
04-736 Warszawa
tel. (022) 815 13 50