Psychological and mental impact of long‐standing incontinence on children and adolescents with complex urologic disorders

Abstract

PurposeIncontinence has a negative impact on the quality of life and is associated with psychiatric disturbances in humans. This study evaluates the impact of long‐standing incontinence on psychological and mental development.MethodsThis is a cohort study carried out in a tertiary care urologic facility. After obtaining an IRB approval, we enrolled 49 children with severe incontinence (incontinence for at least 1 year duration and one surgical intervention) and interviewed between October 2019 and March 2020. Child Behavior Checklist (CBCL) and intelligence quotient (IQ) testing was performed for each using Stanford‐Binet—4th edition. An age‐matched control group was recruited for comparison. A total of 51 children in the control group were later recruited from March 2020 to October 2020 from the Psychiatry Department.ResultsA total of 49 children fulfilled the inclusion criteria. Mean age was 9.93 years, 31 males and 18 females. The etiology of incontinence was neuropathic bladder in 30, exstrophy in 8, incontinent epispadius in 4, valve bladder in 4; common urogenital sinus in 2, and refractory OAB in 1. Median number of procedures was 2 (Range 0–9). Median pads were 5 per day and median hospital stay was 32 days. Median total score of CBCL was 26.5 compared to 7 for the control group (p = 0.00023). Mean IQ of the study group was 88.3 as compared to that of the control (94.65), the difference is significant (p = 0.00023).ConclusionChildren with severe degree of incontinence suffered from significant psychiatric disorders and negative affection of their intelligence. A multidisciplinary approach is advised for management of those children