Voiding disorders among children and adolescents: surveillance after ‘voiding school’ treatment

Abstract

The purpose of this study was to evaluate children's lower urinary tract symptoms (LUTS) and health‐related quality of life (HR‐QoL) 1–6 years after treatment at voiding school. One to six years after the end of treatment for non‐neurogenic voiding disorders, 108 children were contacted (36% girls, current age 8–18 years). The study was conducted in two parts: data were retrospectively collected from the (i) children's medical records to determine their symptoms at the first consultation and (ii) children's current self‐report via two different questionnaires, a voiding‐related symptom questionnaire and a HR‐QoL questionnaire (KINDLN). Fifty‐two children agreed to take part in the study: 17 girls and 35 boys, mean age 12·8 years (SD ± 2·76), median age 13·0 years. At first consultation, 58% of the children suffered from day and night incontinence (DNI), 75% from urgency and 87% from infrequent voiding. Ultrasound showed that 73% had incomplete bladder emptying. No statistically significant sex‐based differences were observed, except that girls more often reported urinary tract infections (P = 0·011). After treatment, 47% of children reported resolution, 39% significant improvement, 12% no improvement and 2% ‘don't know’. DNI was reported by 14%, urgency by 18% and infrequent voiding by 45%. There were no statistically significant correlations between the children's degree of current symptoms and their perceived HR‐QoL. The children reported fewer symptoms after treatment, indicating that attendance at voiding school might be a successful treatment modality. However, the design of the present study does not allow any conclusion to be drawn regarding cause and effect.

Young people's evaluation of a nurse‐led bladder training service: working towards developing a patient reported experience and outcome measure

“…This reflects previous reports on how 'bothersome' managing a bladder condition can be (Mattsson et al, 2010). Conversely, the study by Mohn et al (2010) reported no correlation between Health related QoL (HR-QoL) and LUT symptoms, although a conclusion from their study was the need to ask young people before intervention about their psychosocial well-being. In our project, over half (55%, n = 36) of the children and young people reported sometimes, often or always missing out on social activities as a result of their bladder problems.…”

“…Nurse-led bladder assessment and training clinics or voiding schools have developed over the last decade in many areas including the USA, Europe and the UK and often involve education, biofeedback and behavioural management approaches (Rhodes, 2000;Mattsson et al, 2010;Mohn et al, 2010). There has been limited evaluation or appraisal of the efficacy and patient reported experience of these clinics, with studies predominantly focusing on functional outcomes.…”

“…There has been limited evaluation or appraisal of the efficacy and patient reported experience of these clinics, with studies predominantly focusing on functional outcomes. The study by Mohn et al (2010) focused on longer term outcomes (1-6 years after treatment) using a child self-assessment QoL measure posted to the family. Under half, 47% (n = 24) of children reported resolution of their symptoms following attendance with a further 39% (n = 20) reporting fewer symptoms after treatment.…”