Congenital anomalies of the urinary tract are present in a significant segment of the normal male pediatric population. The majority of the anomalies are of the lower urinary tract and obstructive in nature. Significant obstruction of the lower urinary tract may be expected to produce symptoms or signs which, if the patient were carefully and systematically observed, might lead to diagnosis before infection and renal damage supervene. A logical diagnostic program would screen the normal population and supplement urine studies with planned observation by parents instructed in the normal voiding habits of the male child.
In a recent investigation, a normal male pediatric population was studied for urinary-tract disease by the conventional methods of routine history, physical examination, routine urinalysis, and culture studies. The same population was screened again for lower-urinary-tract obstruction by a program of parent education supplemented by a written questionnaire—the urinary diary. This double screening took place