Urotherapy in children with dysfunctional voiding and the responsiveness of two condition‐specific questionnaires

Noordhoff, Toscane C.; Hoen, Lisette A. ’t; Hoek, Joop van den; Verhallen‐Dantuma, Jacintha T. C. M.; Ledden-Klok, Marjan J. van; Blok, Bertil; Scheepe, Jeroen R.

doi:10.1002/nau.23491

Cited by 9 publications

(6 citation statements)

References 15 publications

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“…11 A recent study by Noordhoof et al found that the VSS was not effective in discriminating between patients who had a clinically significant response to extended urotherapy with biofeedback and those who did not. 12 In our study, we found that both "responders" and "nonresponders" demonstrated statistically significant improvements in symptom scores following at least two sessions of PFBT. The "responders" had an average decrease of nine points (P = <0.0001), a 47% decrease.…”

Section: Discussionmentioning

confidence: 47%

“…PFBT "Responders" were defined as patients demonstrating a change in pelvic floor EMG activity from inappropriately active during the voiding phase pre-PFBT to appropriately quiet during voiding following PFBT therapy. We analyzed symptom score questionnaires only if questions (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13) were answered with an appropriate single answer. The primary outcome measures were quiescence of pelvic floor EMG activity and change in symptom scores over time.…”

Section: Methodsmentioning

confidence: 99%

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Pelvic floor biofeedback therapy in children: Assessment of symptom scores in responders and non‐responders

Taylor

Cabo

Lauderdale

et al. 2018

Neurourology and Urodynamics

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Introduction: Pelvic Floor Biofeedback Therapy (PFBT) can be an effective treatment for pediatric lower urinary tract symptoms (LUTS). Due to differing perceptions of efficacy and practice patterns, we sought to further evaluate PFBT in our practice. We hypothesized that PFBT results in quiescence of EMG activity during voiding and improves questionnaire scores in patients with LUTS. Methods: We retrospectively reviewed all patients undergoing PFBT and refined the analysis to females ≥6 years old with ≥2 sessions with completed voiding questionnaires pre-and post-treatment, active EMG during voiding, with nonneurogenic urinary tract complaints refractory to standard urotherapy. Validated Bladder Bowel Dysfunction (BBD) questionnaires were collected at each visit.Quiescence of EMG activity and changes in BBD score were the primary outcomes. Results: 229 patients underwent ≥1 PFBT session, of which 64 females ≥6 years of age with ≥2 PFBT sessions and completed pre and post PFBT voiding questionnaires were identified. In this group, mean age at PFBT start was 10.1 (6.2-17.0). Patients completed 3.1 sessions (2-6). No difference was seen in post-void residual (PVR) between first and last session (23.8 vs 22.6 mL, P = 0.55). Median questionnaire score decreased from 18 (4-42) before to 13 (2-28) following PFBT (P < 0.0001).Responders, characterized by silencing of the EMG after PFBT, occurred in 31% (20/ 64). Non-responders were younger (P = 0.007) with higher pre-PFBT questionnaire scores. Conclusion: The use of PFBT appears to result in a significant reduction in symptom scores, though quiescence of EMG was observed following therapy in less than 1/3 of patients.

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Section: Discussionmentioning

confidence: 47%

Section: Methodsmentioning

confidence: 99%

Pelvic floor biofeedback therapy in children: Assessment of symptom scores in responders and non‐responders

Taylor

Cabo

Lauderdale

et al. 2018

Neurourology and Urodynamics

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“…Of these, 27 had a complete and 14 a partial response. 29 In a retrospective analysis of 61 patients, 65.5% showed a significant improvement for DV and daytime UI through a biofeedback treatment. 30 Pharmacotherapy is not recommended for DV itself by the ICCS, 20 but can play an ancillary role for comorbid conditions such as OAB.…”

Section: In Childhoodmentioning

confidence: 99%

“…In a recent study of 64 children with DV, 56 underwent extended urotherapy with a median duration of treatment of 18 weeks. Of these, 27 had a complete and 14 a partial response . In a retrospective analysis of 61 patients, 65.5% showed a significant improvement for DV and daytime UI through a biofeedback treatment .…”

Section: Current Management Of DV In Childhoodmentioning

confidence: 99%

Can we improve our management of dysfunctional voiding in children and adults: International Consultation on Incontinence Research Society; ICI‐RS2018?

Tarcan

Gontard

Apostolidis

et al. 2019

Neurourology and Urodynamics

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Aims: Dysfunctional voiding (DV) remains a poorly understood and a poorly managed problem, both in children and adults. The Think Tank (TT) discussed how to improve the management of DV in these two different age groups and in transitional care. Methods: During the 2018 International Consultation on Incontinence Research Society held in Bristol, a multidisciplinary TT on DV was created. The presentations and subsequent discussion, leading to research recommendations intended to improve the management of DV in children and adults are summarized. Results: To improve the management of DV in children and adults, the TT panel proposed: (1) to conduct reliable prevalence studies of DV; (2) to perform longitudinal studies to prospectively test the sequence hypothesis by answering the following questions: (a) Which, if any children show a progression from overactive bladder or voiding postponement to DV?; (b) Which children develop each disorder without precursors?; and (c) Is there a continuation of DV from childhood to adulthood, or are adult cases new-onset presentations?;(3) to obtain detailed information regarding psychopathology to understand which comorbid psychological disorders prevail and at which rate, in those suffering DV; (4) to develop and validate diagnostic tools specifically for DV; (5) to better establish urodynamic correlates of DV specific for different age groups; and (6) to generate prospective long-term data regarding the efficacy of different treatment options and management strategies. Conclusions: The future research recommendations of this TT may improve our management of DV in children and adults. K E Y W O R D S biofeedback, dysfunctional voiding, emptying symptoms, overactive bladder, urethral sphincter, urodynamics

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“…The interprofessional approach for the treatment of PDFs was primarily introduced by pediatricians [12], whose clinical activities were supported by urotherapists treating children with urinary and fecal incontinence [13,14]. A review addressing urotherapy in children revealed that the urotherapist contributed to a reduced urinary and fecal incontinence [13].…”

Section: Introductionmentioning

confidence: 99%

The role of the urotherapist in the care of patients with pelvic floor disorders

Geissbühler¹,

Forst²,

Werner³

et al. 2020

Preprint

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Background: To improve the management of healthcare requirements of pelvic floor disorders (PFDs) in adult patients, interprofessional collaborations are emerging. The aim of this study is to describe and evaluate the activities of a urotherapist in adult patients with PFDs. Methods: The prospective observational study was carried out at the Department of ObGyn at the Cantonal Hospital Winterthur/Switzerland, from July 2016 to June 2018. The activities of the urotherapist were assessed with respect to parameters such as, number of consultations, type of counselling, time frame of consultations and therapy as well patient satisfaction. Demographic and clinical data were collected by self-administered questionnaires and electronic medical data systems. Results: 1709 patients were examined by urogynecologists. Of these patients, 514 (30%) were subsequently referred to a urotherapist. 58% of the 514 patients were over 65 years old. The most common PFDs were complaints about increased bladder sensation such as an overactive bladder, recurrent urinary tract infections, chronic cystitis and pelvic pain syndrome in 221 patients (43%); the second most common was pelvic organ prolapse in 151 patients (29%). The average number of urotherapist consultations per patient was 3 . In the group with >5 consultations, 59% were patients with increased bladder sensation. The most common type of consultation was phone counselling (59% of all activities). Conclusions: Increased bladder sensation related complaints are chronic problems that result in the highest numbers of urotherapist consultations. Interprofessional collaborations between urotherapist, as a specialist nurse, and urogynecologist should be implemented in urogynecological units and further developed in the future.

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Urotherapy in children with dysfunctional voiding and the responsiveness of two condition‐specific questionnaires

Cited by 9 publications

References 15 publications

Pelvic floor biofeedback therapy in children: Assessment of symptom scores in responders and non‐responders

Pelvic floor biofeedback therapy in children: Assessment of symptom scores in responders and non‐responders

Can we improve our management of dysfunctional voiding in children and adults: International Consultation on Incontinence Research Society; ICI‐RS2018?

The role of the urotherapist in the care of patients with pelvic floor disorders

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