Comparative, prospective, and randomized study between urotherapy and the pharmacological treatment of children with urinary incontinence

Campos, Renata Martins; Gugliotta, Antônio; Ikari, Osamu; Perissinoto, Maria Carolina; Lúcio, Adélia Correia; Miyaoka, Ricardo; D’Ancona, Carlos Arturo Levi

doi:10.1590/s1679-45082013000200012

Cited by 7 publications

(7 citation statements)

References 13 publications

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“…However, the evidence level is low as most studies of urotherapy programs are retrospective and non-controlled. Some recent controlled studies show the efficiency of urotherapy over pharmacologic treatment and suggest its use as the initial treatment [40].…”

Section: Managementmentioning

confidence: 99%

EAU-ESPU guidelines recommendations for daytime lower urinary tract conditions in children

et al. 2020

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The objective is to review the literature related to lower urinary tract (LUT) conditions in children to conceptualize general practice guidelines for the general practitioner, pediatrician, pediatric urologist, and urologist. PubMed was searched for the last 15-year literature by the committee. All articles in peer-review journal-related LUT conditions (343) have been retrieved and 76 have been reviewed extensively. Prospective trials were few and the level of evidence was low. Most of the recommendations have been done by committee consensus after extensive discussion of literature reports. History taking is an integral part of evaluation assessing day-and nighttime urine and bowel control, urgency, and frequency symptoms. Exclusion of any neurogenic and organic cause is essential. Uroflowmetry and residual urine determination are recommended in all patients to evaluate bladder emptying. Urodynamic studies are reserved for refractory or complicated cases. Urotherapy that aims to educate the child and family about bladder and bowel function and guides them to achieve normal voiding and bowel habits should initially be employed in all cases except those who have urinary tract infections (UTI) and constipation. Specific medical treatment is added in the case of refractory overactive bladder symptoms and recurrent UTIs.Conclusion: Producing recommendations for managing LUTS in children based on high-quality studies is not possible. LUTS in children should be evaluated in a multimodal way by minimal invasive diagnostic procedures. Urotherapy is the mainstay of treatment and specific medical treatment is added in refractory cases. What is Known:• Symptoms of the lower urinary tract may have significant social consequences and sometimes clinical morbidities like urinary tract infections and vesicoureteral reflux. In many children, however, there is no such obvious cause for the incontinence, and they are referred to as having functional bladder problems. What is New: • This review aims to construct a practical recommendation strategy for the general practitioner, pediatrician, pediatric urologist, and urologist for LUTS in children. Producing recommendations for managing LUTS in children based on high-quality studies is not possible. LUTS in children should be evaluated in a multimodal way by minimal invasive diagnostic procedures. Urotherapy is the mainstay of treatment and specific medical treatment is added in refractory cases.

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Section: Managementmentioning

confidence: 99%

EAU-ESPU guidelines recommendations for daytime lower urinary tract conditions in children

et al. 2020

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“…Antimuscarinic drugs are employed in the treatment of LUTS with encouraging results, (3) as reported by Campos et al, (6) in a study comparing PFMT with the use of oxybutynin in children with NMNE. The PFMT group showed better results in the reduction of incontinence episodes.…”

Section: Introductionmentioning

confidence: 78%

“…The child was instructed to color the figures alone, but the assistance of parents was allowed in case of doubts. (6)…”

Section: Methodsmentioning

confidence: 99%

Pelvic floor muscle training alone or in combination with oxybutynin in treatment of nonmonosymptomatic enuresis. A randomized controlled trial with 2-year follow up

Campos¹,

Lúcio²,

Lopes³

et al. 2019

Einstein (São Paulo)

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Objective To compare the results of the standard urotherapy alone and associated with pelvic floor muscle training alone, and in combination with oxybutynin in treatment of nonmonosymptomatic nocturnal enuresis. Methods A total of 38 children aged 5 to 10 years were randomized into three groups: Group I (n=12) that was submitted to standard urotherapy; Group II (n=15), standard urotherapy associated with pelvic floor muscle training; and Group III (n=11), standard urotherapy associated with pelvic floor muscle training and oxybutynin; the treatment lasted 12 weeks. The assessment tools used were playful bladder diary, and a 48-hour bladder diary, before and after treatment. After 2 years, patients were assessed by telephone using a standardized questionnaire. Results The data of children from the three groups were homogeneous at baseline. After 12-week treatment, all children showed improved symptoms and signs of nonmonosymptomatic nocturnal enuresis, but the differences were not significant among the groups. After 2 years, the three groups showed maintenance of treatment results, but no differences among them. Conclusion All treatment modalities were effective regarding improved enuresis and lower urinary tract symptoms, but the sample was not large enough to show differences among groups.

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“…Hence, there are sparsity of data regarding the efficacy of urotherapy in this group and treatment response in general. An additional question is whether PMFT and timed voiding with watch to improve efficacy of urotherapy as demonstrated in other groups [58,59], but further bladder behavioural treatments may not work in children with behavioural disorder given previous treatment response to bladder behavioural treatments such as alarm therapy [60]. A study by Eliezer et al [61] suggested that urotherapy in a treated cohort of children with behavioural disorders, and improvement would be most noted in the children with day-time incontinence and bladder-bowel dysfunction particularly.…”

Section: Is There Evidence That Pre-treatment Of Behavioural Disorder...mentioning

confidence: 99%

Optimising the management of children with concomitant bladder dysfunction and behavioural disorders

Eliezer

Lam

Smith

et al. 2022

Eur Child Adolesc Psychiatry

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Bladder dysfunction and behavioural disorders in children are commonly concomitant; hence, it is difficult to treat each in isolation. Pharmacotherapy is common treatment for behavioural disorders, and these medications may have intended or unintended positive or negative bladder sequelae. This review identifies the literature regarding the effects of behavioural pharmacotherapy on bladder functioning and possible bladder management strategies in children with concomitant behaviour and bladder disorders to enable clinicians to better manage both conditions. A PROSPERO registered PRISMA-guided review of three major databases was performed. After an initial scoping study revealed significant heterogeneity, a narrative approach was undertaken to discuss the results of all relevant cases relating to children being treated with pharmacotherapy for behaviour disorders and outcomes related to bladder function. Studies were screened to identify those that described effects of commonly prescribed medications in children with behavioural disorders such as stimulants, alpha 2 agonists, tricyclic antidepressants (TCA), serotonin and noradrenergic reuptake inhibitors (SNRI), selective serotonin reuptake inhibitors (SSRI) and antipsychotics, and the findings and implications were summarised. The review identified 46 studies relevant to behavioural pharmacotherapy and bladder function (stimulants (n = 9), alpha 2 agonists (n = 2), TCAs (n = 7), SNRIs (n = 8), SSRIs (n = 8) and antipsychotics (n = 6). Six studies focused specifically on bladder management in children with behavioural disorders with concurrent behavioural pharmacotherapy. This review identifies useful factors that may assist clinicians with predicting unintended bladder effects following initiation of behavioural pharmacotherapy to facilitate the best approach to the treatment of bladder dysfunction in children with behavioural disorders. With this evidence, we have provided a useful decision-making algorithm to aide clinicians in the management of these dual pathologies.

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Comparative, prospective, and randomized study between urotherapy and the pharmacological treatment of children with urinary incontinence

Cited by 7 publications

References 13 publications

EAU-ESPU guidelines recommendations for daytime lower urinary tract conditions in children

EAU-ESPU guidelines recommendations for daytime lower urinary tract conditions in children

Pelvic floor muscle training alone or in combination with oxybutynin in treatment of nonmonosymptomatic enuresis. A randomized controlled trial with 2-year follow up

Optimising the management of children with concomitant bladder dysfunction and behavioural disorders

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