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A novel clinical evaluation of childhood incontinence and urinary urgency
W F Bower1, K H Moore, R D Adams
1Children's Hospital Westmead, Sydney, St. George Hospital, University of New South Wales and School of Physiotherapy, University of Sydney, Sydney, Australia.
Insights
New tools reliably quantify urinary urgency and incontinence in children. The visual analog scale 2 and Dry Pie diary offer objective clinic-based evaluation for pediatric urology.
Area of Science:
- Pediatric Urology
- Child Health Research
Background:
- Objective tools for evaluating urinary urgency and incontinence in children are limited.
- Existing methods may not fully capture the nuances of these conditions in pediatric patients.
Purpose of the Study:
- To introduce and assess the reliability of two novel, child-based tools for quantifying urinary urgency.
- To develop and evaluate a new system for documenting the functional severity of urinary incontinence in children.
Main Methods:
- Analysis of 321 frequency volume charts to establish age-related bladder storage norms (ages 5-12).
- Development and reliability testing of two visual analog scales for urgency quantification (Urgency Visual Analog Scale 1 and 2).
- Design and reliability testing of the 'Dry Pie' diary for functional incontinence assessment.
Main Results:
- Established age-related mean bladder storage volumes and standard deviations for incontinent children.
- Urgency Visual Analog Scale 2 demonstrated reliability for clinical use.
- The Dry Pie incontinence diary proved reliable for a 2-week period and easy for home completion.
Conclusions:
- Clinic-based interventions for pediatric urinary issues can now incorporate reliable quantification of urgency using Urgency Visual Analog Scale 2.
- The Dry Pie diary provides a reliable, functional measure of incontinence severity in children, facilitating home-based documentation.
Purpose:
There are few clinic based objective tools for the evaluation of urinary urgency and incontinence in children. We report on the known method of frequency volume chart, and describe 2 new tools to determine their effectiveness and reliability.
Materials And Methods:
The mean and standard deviation values for affected children in each age group from 5 to 12 years were calculated from 321 consecutive frequency volume charts. Two new child-based scoring tools quantifying urinary urgency were developed to measure the sensation of urgency and the intensity of response at urge (visual analog score 1 and 2). These tools were tested for reliability. As the quantification of incontinence is problematic in children, a new system of documenting functional severity of leakage per day was designed (Dry Pie) and also tested for reliability.
Results:
Age related mean bladder storage volumes and standard deviations were established for children with incontinence. The novel urgency visual analog measure proved reliable, although only scale 2 would be useful in clinical practice. The incontinence Dry Pie diary was also shown to be reliable for 2 weeks and easily completed at home by the children.
Conclusions:
As a result of this study clinic based intervention can include reliable quantification of urinary urgency (visual analog scale 2) and a functional measure of the severity of incontinence (Dry Pie).
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