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Characteristics of Children Successfully Treated for Daytime Urinary Incontinence
Yosuke Morizawa1, Kosuke Mieda1, Akira Tachibana1
1Department of Urology, Nara Medical University, Kashihara, Nara, Japan.
Insights
Standard urotherapy effectively treats most children with daytime urinary incontinence. However, those needing medication often have more severe overactive bladder symptoms and lower voided volumes, indicating a need for tailored treatment strategies.
Area of Science:
- Pediatric Urology
- Continence Management
- Overactive Bladder
Background:
- Daytime urinary incontinence in children is often managed with a stepwise approach.
- Standard urotherapy is the recommended first-line treatment.
- Pharmacological treatment is considered when urotherapy is insufficient.
Purpose of the Study:
- To characterize and compare children with overactive bladder and daytime urinary incontinence.
- To differentiate between those achieving continence with urotherapy alone versus those requiring pharmacological intervention.
- To identify predictors of treatment response in pediatric urinary incontinence.
Main Methods:
- Retrospective study of 221 children with complete daytime continence.
- Analysis of treatment outcomes based on standard urotherapy and pharmacological interventions.
- Comparison of baseline incontinence episodes and voided volumes between treatment groups.
Main Results:
- 47% of children achieved continence with standard urotherapy alone.
- 53% required pharmacological treatment in addition to urotherapy.
- Children needing medication had significantly more daytime incontinence episodes and lower voided volumes.
Conclusions:
- Standard urotherapy is effective for the majority of children with daytime urinary incontinence.
- Half of the patients achieved continence with initial screening and bladder diary use.
- Children requiring pharmacological treatment exhibit more severe overactive bladder characteristics.
Objective:
A stepwise approach is recommended for the treatment of daytime urinary incontinence, with standard urotherapy as the first-line treatment, followed by pharmacological treatment when standard urotherapy is unsuccessful. This study was aimed at characterizing and comparing children with an overactive bladder and daytime urinary incontinence who became continent solely on standard urotherapy and those who achieved continence on a combination of standard urotherapy and pharmacological treatment.
Methods:
This retrospective study included 221 patients with complete continence during the day.
Results:
Of these patients, 104 (47%) were successfully treated with standard urotherapy, and 117 (53%) required pharmacological treatment. Children who achieved continence on a combination of standard urotherapy and pharmacological treatment had significantly more baseline incontinence episodes during the daytime (p = 0.001) and lower voided volumes (voided volume/estimated bladder capacity: 37 and 42 mL respectively, p = 0.0085) compared with children who were treated with standard urotherapy only. Half the patients underwent an initial screening, including the use of a bladder diary, without the need for time-consuming and complex urotherapy.
Conclusions:
Most children achieved daytime continence solely through standard urotherapy. Additionally, half of the patients achieved continence at the initial screening, including the use of the bladder diary. Children requiring additional pharmacological treatment to achieve continence have more severely overactive bladders.
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