Management of urinary incontinence in children with myelomeningocele

Petersen, Thor

doi:10.1111/j.1600-0404.1987.tb07888.x

Cited by 7 publications

(2 citation statements)

References 14 publications

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“…However, our results show that urinary control for two to three hours is perceived as con-siderably more stressful to the child than urinary control for three hours or more. In accordance with other authors (Bille et al 1984, Petersen 1987, we therefore consider that social continence is the ability to stay dry for three hours or more during the day. By using CIC more frequently, social continence may be achieved among a larger proportion of children with myelomeningocele (Cass et al.…”

Section: Discussionsupporting

confidence: 57%

Bowel and Bladder Control of Children With Myelomeningocele: A Nordic Study

Lie

Lagergren

Rasmussen

et al. 1991

Develop Med Child Neuro

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SUMMARY The urinary and bowel control was studied of 527 children with myelomeningocele aged between four and 18 years. Information was obtained from medical records and by parent questionnaire. 44 had normal urinary control, 50 had a urinary diversion and the remaining 433 had neuropathic bladder without urinary diversion, of whom 31 per cent expressed their bladder manually and 40 per cent used clean intermittent catheterisation (CIC). 60 per cent needed assistance emptying their bladder. Children using CIC were more continent and needed less help, but were more often treated with antibiotics. Of the 527 children, 412 had disturbed bowel control. 212 evacuated their bowels manually, of whom 90 per cent needed assistance. Parents judged urinary incontinence to be very stressful for 37 per cent of the children and faecal incontinence for 33 per cent. The authors conclude that social urinary continence should be defined as the ability to keep dry for three hours or more. RÉSUMÉ Contrôle intestinal et vésical chez les enfants porteurs de spina bifida: une étude nordique Le contrôle urinaire et vésical a étéétudié chez 527 enfants avec myéloméngocèle, âgés de quartre à 18 ans. Les informations ont été obtenues à partir des dossiers médicaux et par un questionnaire proposé aux parents. 44 enfants avaient un contrôle urinaire normal, 50 présentaient une dérivation urinaire, le reste étant 433 vessies neurologiques sans dérivation urinaire; parmi ces derniers cas, la vessie était pressée manuellement dans 31 pour cent des cas et le sondage propre intermittent (CIC) était utilisé dans 40 pour cent des cas. 60 pour cent des enfants avaient besoin d'assistance pour vider leur vessie. Les enfants avec CIC étaient plus continents, demandaient moins d'aide, mais étaient plus souvent traités par antibiotiques. Parmi les 527 cas, le contrôle intestinal était perturbeé adans 412 cas. 212 enfants évacuaient leur rectum manuellement, 90 pour cent d'entre eux avaient besoin d'aide. Les parents jugeaient l'incontinence urinaire difficile à supporter chez 37 pour cent des enfants, l'incontinence rectale chez 33 pour cent. Les auteurs concluent que la continence urinaire peut être socialement définie comme une capacitéà demeurer sec trois heures ou plus. ZUSAMMENFASSUNG Darm‐ und Blasenkontrolle bei Kindern mit Myelomeningocele: eine nordeuropäische Studie Bei 527 Kindern mit Myelomeningocele im Alter zwischen vier und 18 Jahren wurden Blasen‐ und Darmkontrolle untersucht. Die Informationen wurden den Krankenakten und den Fragebögen der Eltern entnommen. 44 hatten normale Urinkontrolle, 50 hatten eine Harnableitung, und die restlichen 433 hatten eine neurogene Blase ohne Harnableitung, 31 Prozent davon drückten ihre Blase manuell aus und 40 Prozent benutzten die sterile intermittierende Katheterisierung (CIC). 60 Prozent waren bei der Blasenentleerung auf Hilfe angewiesen. Kinder, die die CIC benutzten, hatten eine bessere Kontinenz und brauchten weniger Hilfe, sie wurden aber häufiger mit Antibiotika behandelt. Von den 527 Kindern h...

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Section: Discussionsupporting

confidence: 57%

Bowel and Bladder Control of Children With Myelomeningocele: A Nordic Study

Lie

Lagergren

Rasmussen

et al. 1991

Develop Med Child Neuro

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“…After removing 16 duplicates, we screened the titles and abstracts of 193 references. Eleven studies were analyzed in full text, and five were excluded: four were not RCTs, [16][17][18][19] and one study included participants with another neurological dysfunction (RBR-4qjdxq). In addition, two studies were classified as "awaiting classification" due to not having been found in full text.…”

Section: Results Of the Searchmentioning

confidence: 99%

Efficacy and safety of electrical stimulation in the treatment of neurogenic bladder dysfunction in myelomeningocele—Systematic review of randomized clinical trials

Silva

Horliana

Santos

et al. 2021

Neurourology and Urodynamics

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Aims: The purpose of this systematic review was to investigate and synthesize the effects (benefits and harms) of electrical stimulation (EE), alone or in association with other interventions, compared with sham and other interventions, for the treatment of neurogenic bladder dysfunction in myelomeningocele. Methods: This systematic review was conducted following the methodological recommendations of the Cochrane Handbook for Systematic Reviews of Interventions and registered at PROSPERO (CRD42020200425). A search was performed in the following electronic databases: MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, LILACS, and PEDro. Randomized clinical trials (RCTs) that assessed any EE in children diagnosed with myelomeningocele and neurogenic bladder and/or urinary incontinence were included and reported.Results: When comparing EE versus sham groups, some estimated effects showed a wide confidence interval, probably due to the small sample size of the included studies. This indicates an imprecision in these findings. Regarding the safety of this intervention and safety of the lower urinary tract, no adverse events resulting from EE were reported. All the included studies have evaluated the efficacy of EE compared with sham, but different EE parameters and electrode positions among studies make it impossible to perform a meta-analysis. Conclusions: Based on very low certainty evidence, the findings of this systematic review suggested no difference between EE and sham to improve urinary incontinence in children with myelomeningocele. However, the small sample size and the imprecision arising from the wide confidence intervals must be considered. Future RCTs following a rigorous methodology, as

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