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Can lockdown and homeschooling change the outcome of urotherapy for lower urinary tract dysfunction in children?
Aykut Akinci1, Can Utku Baklaci2, Efe Semetey Oğuz2
1Department of Pediatric Urology, Ankara University School of Medicine, Cebeci Children's Hospital, Ankara, Turkey.
Insights
The COVID-19 lockdown and homeschooling enhanced the effectiveness of urotherapy for treating pediatric lower urinary tract dysfunction (LUTD). This suggests environmental conditions can optimize urotherapy outcomes for improved quality of life.
Area of Science:
- Pediatric Urology
- Urotherapy Efficacy
- Public Health Interventions
Background:
- Lower urinary tract dysfunction (LUTD) remains a significant concern in pediatric urology.
- Urotherapy is a cornerstone treatment for pediatric LUTD.
- The COVID-19 pandemic necessitated widespread lockdowns and homeschooling, altering daily routines for children.
Purpose of the Study:
- To evaluate the impact of COVID-19 lockdown and homeschooling on the effectiveness of urotherapy in treating pediatric LUTD.
- To compare treatment outcomes between children undergoing urotherapy during lockdown and a pre-pandemic control group.
Main Methods:
- A study group of 83 patients undergoing urotherapy during lockdown was compared to a control group of 306 patients from before the pandemic.
- Outcomes assessed included the Dysfunctional Voiding and Incontinence Scoring System (DVISS), quality of life scores, bladder diaries, and Bristol stool scale.
- Comparisons were made at 3 and 6 months of treatment.
Main Results:
- The lockdown group showed a significantly lower mean DVISS at 6 months (7.12 vs. 8.58, p=0.002).
- The study group had significantly fewer daily incontinence episodes at 3 months (0.57 vs. 0.94, p=0.02).
- Complete or partial treatment response rates were higher in the lockdown group (58% vs. 45.1%, p=0.02).
Conclusions:
- Standard urotherapy demonstrated increased success rates during the COVID-19 lockdown and homeschooling period.
- Regulating environmental conditions, such as those during lockdown, can potentially improve urotherapy outcomes for pediatric LUTD.
- Optimizing environmental factors offers a promising avenue for more economical and effective LUTD management, enhancing patient quality of life.
Objective:
Lower urinary tract dysfunction (LUTD) are still important for both children and pediatric urologists. Urotherapy is recommended in LUTD treatment management. In our country, all citizens under the age of 20 were banned from going out of their homes due to Covid-19 and the homeschooling system has been adopted The aim of this study is to investigate the effect of lockdown and homeschooling on the effectiveness of urotherapy used for LUTD treatment.
Methods:
83 patients were included in the study group. Besides 306 patients were determined as the control group (pre-Covid). The patients in the study group and the control group were compared in terms of improvement in Dysfunctional voiding and incontinence scoring system (DVISS), quality of life scores, bladder diary, Bristol stool scale, and treatment responses at 3rd and 6th months.
Results:
The study group and control group were compared in terms of DVISS, voiding frequency and incontinence in the voiding diary, quality of life score, and Bristol stool scale at admission visit and the group characteristics were similar. During the 6th month visit, the mean DVISS of the study group was found to be significantly lower (7.12 ± 3.48; 8.58 ± 4.06 respectively (p 0.002)). Daily voiding frequency was similar in the study group and the control group during the 2nd and 3rd visit. The study group's mean number of daily incontinence was significantly lower at visit 3 (0.57 ± 0.9; 0.94 ± 0.27, respectively (p 0.02).After six months of treatment, 13.3% of the study group patients had a complete response, 44.6% had a partial response, whereas 42.2% non-responders. In the control group, the response rates were as 5.9%, 39.2% and 54.9% respectively (p 0.02).
Conclusions:
LUTD is still very common in pediatric urology. Standard urotherapy is widely used in treatment management. According to our results, the success of standard urotherapy increases with lockdown and homeschooling. We have shown that the success of standard urotherapy can be improved by regulating environmental conditions. In terms of LUTD management, environmental conditions can be regulated to provide a better quality of life and a better cure in a more economical way.
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