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The voiding alert system: a new application in the treatment of incontinence
K P Murphy1, E M Kliever, M J Moore
1Department of Pediatrics, Polinsky Medical Rehabilitation Center, Duluth, MN.
Insights
The voiding alarm system, initially for childhood nocturnal enuresis, shows promise in adults. This system alerts caregivers to voiding in individuals unable to communicate, improving incontinence management.
Area of Science:
- Urology
- Geriatrics
- Rehabilitation Medicine
Background:
- The voiding alarm system was initially designed for pediatric nocturnal enuresis (bedwetting).
- Its adoption by American clinicians, including pediatricians, has been limited.
- This study explores novel applications of the voiding alarm system in diverse patient groups.
Observation:
- The core concept involves alerting care attendants to voiding episodes in individuals with impaired awareness or communication.
- Case studies included patients in long-term care facilities with conditions such as neurogenic bladder, spina bifida, spinal cord injury, stress incontinence, and organic brain syndrome.
Findings:
- The system facilitated accurate measurement of post-void residual volumes.
- It aided in optimizing oxybutynin chloride medication dosage to the lowest effective level.
- Indwelling urinary catheter use was eliminated in cases of incontinence-related perineal skin breakdown.
Implications:
- The voiding alarm system offers a valuable tool for managing incontinence in non-communicative or unaware individuals.
- Potential exists for expanding its use across various clinical settings beyond pediatrics.
- This technology can enhance patient care, reduce complications, and potentially lower healthcare costs.
Abstract:
The voiding alarm system was developed to control nocturnal enuresis in children more than 5 years of age. Its acceptance by American clinicians, including pediatricians, has been modest at best. This article describes a new application of the voiding alarm system in different patient populations. The concept is that of notifying care attendants of voiding by individuals who are unaware or unable to communicate. Five case examples are presented involving individuals in a long-term care facility with neurogenic bladder, spina bifida, traumatic spinal cord injury, stress incontinence, and organic brain syndrome. Benefits were documented with respect to accurate measurements of post-void residual volumes, titering of oxybutynin chloride medication to the minimum effective dose, and the elimination of indwelling urinary catheters in the treatment of incontinence causing perineal skin breakdown. Further developments of the voiding alarm system are postulated for use in multiple clinical environments.