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  🚽 Why It Matters Pediatric voiding dysfunction is one of the most  common but underappreciated referrals  to pediatric radiologists. While most children with urinary incontinence don’t have an underlying anatomic abnormality, imaging can be the  key to unlocking missed diagnoses , guiding treatment, and providing parental reassurance. This blog post explores the  embryology, neural control, clinical presentation , and  radiologic approach  to voiding dysfunction in children — so you, as a radiology resident, know when and what to look for. 🧬 The Embryologic Link: Why Bladder and Bowel Go Hand-in-Hand During 4–6 weeks of gestation, the  cloaca divides  into the bladder (anterior) and rectum (posterior). This shared origin means: Both organs are innervated by  S2–S4 sacral segments Dysfunction in one often affects the other Constipation can worsen urinary incontinence 🔁  Think of it as a two-way street between rectal and bladder ...

  Ever received a fetal scan report saying “mild pyelectasis,” and then the postnatal ultrasound called it “hydronephrosis”? Was it the same thing? Did it need follow-up? Antibiotics? A VCUG? Or was it just going to resolve on its own? If you’ve been asking these questions in your rounds or reports—you’re not alone. Let’s unravel the  why ,  what , and  how  of the updated  UTD Classification System  for pediatric urinary tract dilation, and why it matters for us as residents in radiology and pediatrics alike. 🔍  Why was a new classification system needed? Confusing Terminology : Terms like  hydronephrosis ,  pyelectasis ,  pelviectasis , and  pelvicaliectasis  were being used interchangeably—but not consistently. Disjointed Communication : Antenatal and postnatal reports often didn’t “speak the same language.” Pediatricians, nephrologists, urologists, and radiologists all interpreted the findings differently. Missed or O...