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Standard urotherapy as first-line intervention for daytime incontinence: a meta-analysis
S K Schäfer1, J Niemczyk2, A von Gontard2
1Department of Psychology, Saarland University, Building A 1.3, 66123, Saarbrücken, Germany. sarah.schaefer@uni-saarland.de.
European Child & Adolescent Psychiatry
|September 27, 2017
Summary
Standard urotherapy (SU) effectively treats daytime urinary incontinence (DUI) in children and adolescents. This meta-analysis shows SU increases recovery probability by over 7 times compared to spontaneous remission.
Area of Science:
- Pediatric Urology
- Clinical Effectiveness Research
Background:
- Daytime urinary incontinence (DUI) affects many children and adolescents.
- Standard urotherapy (SU) is recommended as a first-line intervention by the International Children's Continence Society (ICCS).
- A meta-analysis on SU's effectiveness was lacking.
Purpose of the Study:
- To evaluate the effectiveness of standard urotherapy (SU) for treating daytime urinary incontinence (DUI) in pediatric populations.
- To compare remission rates after SU to spontaneous remission rates.
Main Methods:
- Meta-analysis of 26 patient samples from 19 studies (N=1609).
- Calculated Odds Ratios (OR) to compare SU effectiveness against spontaneous remission.
- Matched spontaneous remission rates to individual follow-up periods.
Main Results:
- Standard urotherapy (SU) significantly increases the probability of recovery from DUI by a factor of 7.27 compared to spontaneous remission (15.40% per year).
- Approximately 56% of patients treated with SU remit within one year, versus 15% spontaneously.
- Effectiveness is generalizable across DUI types and pediatric populations, though RCTs showed lower effects.
Conclusions:
- Standard urotherapy (SU) is a highly effective treatment for daytime urinary incontinence (DUI) in children and adolescents.
- SU demonstrates a substantial improvement over spontaneous remission rates.
- Further RCTs are needed to precisely quantify SU's effect size against spontaneous remission and other interventions.
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