Multi-center randomized controlled trial of cognitive treatment, placebo, oxybutynin, bladder training, and pelvic floor training in children with functional urinary incontinence

Gool, Jan D. van; Jong, Tom P.V.M. de; Winkler-Seinstra, Pauline; Tamminen-Möbius, T.; Lax, Hildegard; Hirche, H.; Nijman, Rien J.M.; Hjälmås, K; Jodal, Ulf; Bachmann, H.; Hoebeke, Piet; Walle, Johan Vande; Misselwitz, Joachim; John, U; Bael, An

doi:10.1002/nau.22446

Cited by 73 publications

(50 citation statements)

References 29 publications

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“…Dysfunctional voiding was treated with timed voiding and positive reinforcement regimens, bowel regimens (including high daily fluid intake, a diet high in fiber, and stool softeners if necessary), biofeedback therapy, medications of alpha-blockers and/or antibiotics [19].…”

Section: Disease Categories and Managementmentioning

confidence: 99%

The role of occult spinal malformation and upper urinary tract deterioration in children with intractable voiding dysfunction

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Objectives: To evaluate the presence of upper urinary tract deterioration (UUTD) and accompanying pathologies in children treated with the diagnosis of non-neurogenic bladder-sphincter dysfunction (NNBSD). Patients and Methods:We retrospectively reviewed the medical records of 316 consecutive patients with NNBSD who were treated. All cohort were grouped into two: Group I (Treatment success; n=284), Group II (Treatment failure with any form of occult spinal pathology; n=32). Thirty-four children with treatment-failure and normal magnetic resonance imaging (MRI) findings were excluded. Groups were compared for pre-and posttreatment pediatric lower urinary tract symptom score (PLUTSS), presence of UUTD and urodynamic findings. Results:The mean PLUTSS was significantly less in Group I compared with Group II at pre-treatment and 3 months thereafter the initial treatment (12.20 ± 5.90 and 5.20 ± 4.90 vs 20.3 ± 2.14 and 18 ± 3.4, respectively p<0.01). The mean cystometric capacities and detrusor leak point pressure (DLPP) of Group II prior to initial treatment and after 6 months of the untethering surgery were found to be 194, 267 mL and 28, 12cm H2O, respectively (p<0.05). Presence of UUTD was significantly correlated with DLPP >20 cm H2O and presence of vesicoureteral reflux (VUR).Conclusion: UUTD in NNBSD is more common in children with occult spinal pathology, than in those without.Keywords: Non-neuropathic bladder sphincter dysfunction, Upper urinary tract deterioration, Symptom score ÖZ Amaç: Nörojenik olmayan mesane-sfinkter fonksiyon bozukluğu (NOMSFB) tanısıyla tedavi edilen çocuklarda üst üriner sistem hasarı (ÜÜSH) ve eşlik eden patolojilerin araştırılmasıdır. Hastalar ve Yöntemler:NOMSFB nedeniyle kliniğimizde tedavi edilen 316 çocuğun tıbbi kayıtları retrospektif olarak incelendi. Çocuklar, tedavi yanıtına ve magnetic resonans görüntüleme (MRG) bulgularına göre iki gruba ayrıldılar: Grup I (Tedaviye yanıt verenler; n=284) ile Grup II (Tedaviye dirençli olup, lomber MRG'sinde gizli spinal disrafizm bulgusu olanlar; n=32). Tedaviye dirençli olup lomber MRG'sinde patoloji saptanmayan 34 çocuk çalışma dışı bırakıldı. Gruplar tedavi öncesi ve sonrası semptom skoru (SS), ÜÜSH ile ürodinami bulguları açısından karşılaştırıldı. Bulgular:Tedavi öncesi dönemde ve tedavi başladıktan üç ay sonra, Grup I'in ortalama SS'si Grup II'ye göre anlamlı olarak düşük saptandı (sırasıyla 12,20 ± 5,90 ve 5,20 ± 4,90 karşın 20,3 ± 2,14 ve 18 ± 3,4; p<0.01). Grup II'nin başlangıç tedavisi öncesi ortalama sistometrik kapasitesi ve detrüsör kaçırma anı basıncı (DKAB) sırasıyla 194 ml ve 28 cm H2O olarak saptandı. Grup II'nin gergin omurilik onarımını takip eden altıncı ayda ortalama sistometrik kapasite ve ortalama DKAB sırasıyla 267 ml ve 12 cmH2O olarak saptandı. ÜÜSH varlığı ile DKAB'ın 20 cmH2O üzeri olması ve vezikoüreteral reflü varlığı arasında anlamlı ilişki bulundu.Sonuç: NOMSFB'da ÜÜSH, gizli spinal disrafizm varlığında daha sık görülür.Anahtar kelimeler: Nörojenik olmayan mesane-sfinkter fonksiyon bozukluğu, Üst ü...

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Section: Disease Categories and Managementmentioning

confidence: 99%

The role of occult spinal malformation and upper urinary tract deterioration in children with intractable voiding dysfunction

Tanıdır

Şener

Sekerci

et al. 2017

MMJ

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“…In recent ICCS publications, pelvic floor overactivity remains outside the definition and defined pathophysiological mechanism, even if in their recommendations, the authors insist on the need for evaluation and correction of pelvic floor disorders [37]. Other authors insist on the primary role played by a hypertonic sphincter as a possible isolated problem called primary bladder neck dysfunction [94].…”

Section: Lut Dysfunction (Lutd) (Or Daytime Condition or Non-neurogenmentioning

confidence: 99%

“…The issue comes down to the question of the chicken and the egg. The ICCS mainly considers urethral sphincter overactivity as the more important trouble [94], but this affirmation is not consensual. In addition, the therapeutic approach frequently conjugates actions on the two phases of miction.…”

Section: Lut Dysfunction (Lutd) (Or Daytime Condition or Non-neurogenmentioning

confidence: 99%

“…Following previous publications, the European Bladder Dysfunction Study (EBDS) recognized two clinical conditions in 217 patients [94].…”

Section: Lut Dysfunction (Lutd) (Or Daytime Condition or Non-neurogenmentioning

confidence: 99%

“…This initial step should involve education of the child/family regarding bowel/bladder dysfunction, timed voiding, adequate fluid intake, aggressive management of constipation, and hygiene (changing of wet clothing, containment products, skin care, and correct wiping technique) [94]. The ICCS formulated recommendations for the management of constipation [21].…”

Section: Treatment Of Lutdmentioning

confidence: 99%

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