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Flaccid Bladder/Atonic Bladder

My son is 11 years old, weighs about 63lbs and has had a problem with incontience since he was potty trained.  He has never had a problem with bed wetting.  His only problem is that he has no bladder awareness.  He has no feeling that he needs to void until some urine is released from his bladder.  A few times he has totally wet his pants, but most of the time it is just "dribbles".  Just recently he had a renal ultrasound at the advice of his Genetisist who thinks he might have Branical-oto-renal syndrom.  During this ultrasound they asked my son to go to the bathroom and empty his bladder.  When he returned the ultrasound showed that his bladder was only half the size it was before he voided, he could not empty his bladder fully.  He stated that he didn't have to go to the bathroom anymore, that he felt fine.  
After reading up on flaccid bladder/atonic bladder I see that he has every symptom of it, and my question is what could be causeing this?  He has had no spinal injury.  My next question is who should he be seeing for this problem?  A Urologist? Or a neurologist?  I also wonder if this problem with his bladder is related to BOR syndrome?

Thank you very much for this service. :)
Danyelle
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Dear Danyelle,
When a patient has difficulty with bladder control/sensation he needs to be worked up by a urologist. This would may include a series of tests such as blood tests, x-ray studies and urodynamic studies. The latter is bladder test which helps define the functional characteristics of his bladder. These tests will help the urologist decide about how to treat your son.
Branchio-Oto-Renal(BOR) syndrome, otherwise known as Melnick-Fraser syndrome, is an inherited autosomal dominant trait, as you may already know, with an estimated prevalence of 1 in 40,000 births.The primary urologic abnormalities are associated kidney anomalies such as polycystic kidneys (kidneys with multiple cysts), renal agenesis (lack of development of a kidney), renal hypoplasia(development of small kidneys), etc. There usually is no known bladder abnormality associated with BOR. Therefore, his bladder problem is a separate problem.  Regardless, you should see a urologist initially.
This information is provided for general medical information purposes only. Please consult  your physician for diagnostic and treatment options pertaining to your specific medical condition. Dr.S.Liroff at our institution has experience in enuresis and I would highly recommend that you see him for this problem. If you would like to make an appointment , please call us at  1-800-653-6568. We can also arrange local accommodations through this number if this is  your need. Please bring any x-rays [and pathology slides] (not just the reports) as well as any physicians
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