Bladder and Bowel Dysfunction Network: Improving the Management of Pediatric Bladder and Bowel Dysfunction.

Area of Science:

• Pediatric Urology
• Community Health
• Behavioral Pediatrics

Background:

• Bladder and bowel dysfunction (BBD) presents with lower urinary tract symptoms and constipation.
• High referral volumes to pediatric urology clinics lead to prolonged wait times.
• Initial BBD management involves behavioral strategies suitable for community pediatricians.

Purpose of the Study:

• To establish a Bladder and Bowel Dysfunction Network (BBDN) of community pediatricians.
• To assess the impact of the BBDN on patient care and wait times.
• To compare BBDN management with traditional hospital pediatric urology clinic care.

Main Methods:

• Pediatricians received training in BBD management through lectures and clinical shadowing.
• Patients referred to pediatric urology were triaged to the BBDN or remained in the hospital clinic.
• Dysfunctional voiding symptom score, Bristol stool chart, and satisfaction surveys were used for assessment.

Main Results:

• Community pediatricians primarily used PEG3350 and diet for BBD management, less often recommending bladder retraining.
• Both BBDN and hospital clinic groups showed similar improvements in dysfunctional voiding symptom scores.
• BBDN patients experienced significantly shorter wait times for follow-up appointments (56 days vs. 94.5 days).

Conclusions:

• Community pediatricians may benefit from enhanced knowledge of BBD management strategies.
• Implementing a BBDN is feasible and reduces wait times for pediatric BBD care.
• The BBDN model achieves comparable symptom improvement and patient satisfaction to hospital-based clinics.