Overactive bladder in children

Ramsay, Sophie; Bolduc, Stéphane

doi:10.5489/cuaj.4337

Cited by 29 publications

(30 citation statements)

References 75 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%

“…Standard therapy for both children and adults with non-neurogenic UI/FI in Canada includes behavioral and dietary changes, biofeedback, and pharmacological treatments ( 6 ). Medications, in particular antimuscarinics, may elicit adverse effects (dry eyes, dry mouth, constipation, GI upset, heat intolerance) but can provide effective treatment outcomes in most patients.…”

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 condition may have a negative impact on self-confidence and quality of life, feeling of shame, poor progress at school, aggression. The quality of life of the patients with LUTS and their families is profoundly impacted but can be easily improved with adequate treatment [1,8,15].…”

Section: Discussionmentioning

confidence: 99%

“…A lifestyle modification may be the only therapy needed in the majority of patients. Antimuscarinic agents are most commonly used for the treatment of OAB, with or without behavioral treatment [8].…”

Section: Introductionmentioning

confidence: 99%

Biofeedback in the treatment of lower urinary tract symptoms in children

Djermanov

Zivkovic

2018

Med pregl

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Introduction. Bladder and bowel dysfunction describes a large spectrum of lower urinary tract symptoms along with fecal elimination issues. The aim of the study was to analyze the effects of biofeedback treatment in children with lower urinary tract symptoms. Material and Methods. A prospective study analyzed the effects of biofeedback treatment conducted in children with lower urinary tract symptoms. Questionnaires and voiding diaries were collected prior to the treatment. The patients were followed for two weeks on daily basis. After the completion of the treatment, the data from voiding diaries and questionnaires were analyzed. Results. A total of 18 children were referred for biofeedback treatment. Seven patients had an overactive bladder. seven had isolated dysfunctional voiding, and in the third group three had difficulties starting to void and one had daily incontinence with dysfunctional voiding. A total of 14 patients presented with improvement of symptoms. The analyzed data showed no measurable improvement in one patient, even though he reported a personal feeling of improvement. Three patients without positive effects of the therapy were immature and non-cooperative. In six out of seven patients with overactive bladder with urine leakage, the symptom disappeared by the end of the treatment. Conclusion. Biofeedback is a very useful tool in the treatment of lower urinary tract symptoms in pediatric population. Although the main indication for initiating this therapy is dysfunctional voiding, the study showed an improvement of symptoms in patients with overactive bladder as well.

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“…Children that have troubles with incontinence have a three to fold greater incidence of behavioral and psychiatric disorders than that of the age-matched general population [7]. A stepwise approach is favored to treat this pathology, beginning with urotherapy, a behavioral therapy, followed by pharmacological treatment, and invasive procedures in the end [8]. Urotherapy, starting with education of the children and their family, has several phases, including timed voiding, management of constipation and pelvic floor training.…”

Section: Introductionmentioning

confidence: 99%

Comparative assessment of efficacy and safety of different treatment for de novo overactive bladder children: A systematic review and network meta-analysis

Qiu

Lin

et al. 2019

Asian Journal of Urology

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ObjectiveTo compare these managements focusing on the efficacy and safety to treat overactive bladder (OAB) in children through network meta-analysis (NMA).MethodsWe searched PubMed, Embase, the Cochrane Library Central Register of Controlled Trials (CENTRAL) and the reference lists up to May 1st, 2017. Data from eligible randomized controlled trails (RCT) studies including three different treatment options were extracted. The primary outcome was maximal voiding volume (MVV). We performed pairwise meta-analyses by random effects model and NMA by Bayesian model. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework to assess the quality of evidence contributing to each network estimate.ResultsSix RCTs (462 patients) comparing three different interventions fulfilled the inclusion criteria. A low risk of bias was shown for the majority of the study items. The results of NMA showed that compared with antimuscarinic drugs, Parasacral transcutaneous electrical nerve stimulation was associated with significant improvement in the MVV (mean difference [MD] = 58.50, 95% confidential interval [CI]: 45.95–69.52), followed by urotherapy group (MD = 21.03, 95% CI: 11.85–29.97). When it comes to the constipation, antimuscarinic drugs exerted significant benefit than PTENS (odds ratio [OR]: 0.22, 95% CI: 0.01–0.46). No significant difference was found between other treatments.ConclusionCompared with antimuscarinic drugs, PTENS was associated with significant better efficacy considering MVV, but more constipation events in de novo OAB children. Antimuscarinic drugs showed remarkably better efficacy considering MVV and comparable safety profile compared with urotherapy. Clinicians should take all known safety and compliance of patients into account when choosing an optimal strategy.

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Overactive bladder in children

Cited by 29 publications

References 75 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)

Biofeedback in the treatment of lower urinary tract symptoms in children

Comparative assessment of efficacy and safety of different treatment for de novo overactive bladder children: A systematic review and network meta-analysis

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