Diagnosis and management of bladder bowel dysfunction in children with urinary tract infections: a position statement from the International Children’s Continence Society

Yang, Stephen Shei‐Dei; Chua, Michael; Bauer, Stuart B.; Wright, Anne; Brandström, Per; Hoebeke, Piet; Rittig, Søren; Gennaro, M. De; Jackson, Elizabeth; Fonseca, Eliane Garcez da; Nieuwhof-Leppink, Anka; Austin, Paul F.

doi:10.1007/s00467-017-3799-9

Cited by 63 publications

(56 citation statements)

References 140 publications

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“…Less is known about the parental burden of a child's refractory UI/FI. Studies that examined the impact of parental well-being in similar populations indicate a general decrease in QoL (5,6). In this study, pressures on caregivers led to altered family dynamics, marital discourse, and financial burden, consistent with previous publications (28).…”

Section: Discussionsupporting

confidence: 85%

“…BBD describes a multitude of lower urinary tract symptoms (LUTS), often accompanied by constipation and/or encopresis. BBD is also commonly associated with vesicoureteral reflux (VUR) and recurrent (febrile) urinary tract infections (UTIs), which can ultimately impact renal function (5). Incontinence also affects children's psychosocial well-being including anxiety, self-esteem, shame, isolation, poor school performance, and other behavioral changes (4).…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Needs in Children Suffering From Refractory Non-neurogenic Urinary and Fecal Incontinence and Their Caregivers' Needs and Attitudes Toward Alternative Therapies (SNM, TENS)

et al. 2020

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Background: Non-neurogenic urinary and fecal incontinence (UI, FI) affects approximately 6% of North American children with 1% of cases becoming refractory (nonresponsive to standard therapies). Incontinence has major potential long-term physiological and psychological implications for patients and their families. While Sacral Neuromodulation (SNM) and Transcutaneous Nerve Stimulation (TENS) are alternative therapies available for the treatment of refractory UI/FI, these are not approved for use in children in Canada. The present study assessed participants' perception of current treatments, incontinence burden, and attitudes toward novel therapies in a single pediatric institution. Methods: Multiple validated questionnaires including Dysfunctional Voiding Scoring System (DVSS), Bristol Stool Chart (BSC), Pediatric Incontinence measurement (PinQ), and Time-Driven Activity Based Costing were used to perform a needs assessment for patients with non-neurogenic refractory incontinence, and to determine patients' and caregivers' attitudes toward alternative therapies. Results: 75% of patients and 89% of caregivers reported a moderate to severe impact of incontinence on QoL with diminished social interactions among the primary concerns. Caregivers were frustrated with current treatments and were open to trying alternative therapies (SNM and TENS), which, at least in the case of SNM, seems to be less expensive, possibly less burdensome and more effective than current surgical options. Dos Santos et al. Pediatric Incontinence Burden Conclusion: Pediatric refractory UI/FI has a large impact on patients' and caregivers' QoL and alternative therapies with the potential to improve QoL of patients and caregivers should be further investigated as a substitute for surgery.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Assessment of Needs in Children Suffering From Refractory Non-neurogenic Urinary and Fecal Incontinence and Their Caregivers' Needs and Attitudes Toward Alternative Therapies (SNM, TENS)

et al. 2020

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“…The existence of large stool masses accompanied by volitional holding because of pain with defecation delays/prevents whole bladder emptying. This mechanism leads to the high accumulation of post-void residuals facilitating bacterial colonization (such as E. coli) in the bladder [28,29]. The guideline available in the American Academy of Pediatrics recommends pyuria as a clinical factor to diagnose UTIs [30].…”

Section: Discussionmentioning

confidence: 99%

Clinical Manifestations, Laboratory Markers, and Renal Ultrasonographic Examinationsin 1-month to12-year-old Iranian Children with Pyelonephritis: A Six-year Cross-sectional Retrospectivestudy

Fahimi

Khedmat

Afshin

et al. 2020

Preprint

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Background: Upper urinary tract infection (UTI) or pyelonephritismay increase the pathogenesis rate and risk of severe complications in children due to the atrophy of the kidneys.Objective: A set of clinical symptoms, laboratory markers, and ultrasound findings were assessed to reach early diagnosis and prognosis of pyelonephritis in hospitalized pediatrics.Methods: A cross-sectional study was conducted on 104 Iranian children (95 girls and 9 boys) aged 1 month to 12 years with acute pyelonephritis during 2012-2018. The ultrasound examination of kidneys and urinary tract during the hospitalization period, the incidence of clinical symptoms, and the monitoring of laboratory markersin blood and urine were studied to identify the best predictive factors of early diagnosis of this bacterial infection.Results: Three-fourth of the patients had one of the four clinical symptoms of abdominal pain, constipation, dysuria, andvomiting, whileotherswere asymptomatic. A considerable frequency of pyuria(88.4%), Escherichia coli in urine (92%), leukocytosis (81.7%), and high ESR (> mm/h, 80%) and CRP (> 10mg/L, 82.8%) was observed. The kidney and urinary tract ultrasonography onlyin 32.7% of children showed in favor of pyelonephritis (cystitis, ureteral stones, and hydronephrosis).Conclusion: In the majority of patients, there was a high prevalence of clinical signs and laboratory markers associated with pyelonephritis. Since most patients have normal sonography, ultrasound alonecould notbe an efficient tool fortracingfebrile UTI.

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“…BBD has also been reported to impact the rate of breakthrough UTIs in patients with VUR who are on continuous antibiotic prophylaxis (5). As the presence of BBD in patients with UTI affects long-term outcomes, early recognition, and treatment are essential (6). In patients with UTI, variable prevalence (18-54%) of BBD has been reported in previous studies.…”

Section: Introduction Rationalementioning

confidence: 98%

“…The risk of UTI is higher in patients with BBD and primary vesicoureteral reflux (VUR) than in patients with only VUR (5). Presence of BBD delays resolution of VUR and increases risk of UTI following reimplantation (6,7). BBD has also been reported to impact the rate of breakthrough UTIs in patients with VUR who are on continuous antibiotic prophylaxis (5).…”

Section: Introduction Rationalementioning

confidence: 99%

Prevalence of Bladder and Bowel Dysfunction in Toilet-Trained Children With Urinary Tract Infection and/or Primary Vesicoureteral Reflux: A Systematic Review and Meta-Analysis

et al. 2020

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Diagnosis and management of bladder bowel dysfunction in children with urinary tract infections: a position statement from the International Children’s Continence Society

Abstract: This document serves as the position statement from ICCS, based on literature review and expert opinion providing our current understanding of BBD in children with UTI.

Cited by 63 publications

References 140 publications

Assessment of Needs in Children Suffering From Refractory Non-neurogenic Urinary and Fecal Incontinence and Their Caregivers' Needs and Attitudes Toward Alternative Therapies (SNM, TENS)

Assessment of Needs in Children Suffering From Refractory Non-neurogenic Urinary and Fecal Incontinence and Their Caregivers' Needs and Attitudes Toward Alternative Therapies (SNM, TENS)

Clinical Manifestations, Laboratory Markers, and Renal Ultrasonographic Examinationsin 1-month to12-year-old Iranian Children with Pyelonephritis: A Six-year Cross-sectional Retrospectivestudy

Prevalence of Bladder and Bowel Dysfunction in Toilet-Trained Children With Urinary Tract Infection and/or Primary Vesicoureteral Reflux: A Systematic Review and Meta-Analysis

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