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The objective assessment of urinary incontinence in children
N Imada1, A Kawauchi, Y Tanaka
1Department of Urology, Kyoto Prefectural University of Medicine, Japan.
Insights
A new pad-weighing test for childhood urinary incontinence showed better correlation with symptoms than the standard 1-hour pad-weighing test, aiding objective assessment.
Area of Science:
- Pediatric Urology
- Diagnostic Methods in Urology
- Child Health
Background:
- Urinary incontinence in children presents a significant clinical challenge.
- Objective assessment methods are crucial for accurate diagnosis and management.
- Existing methods may not fully capture the nuances of pediatric incontinence.
Purpose of the Study:
- To objectively assess urinary incontinence in children.
- To compare the efficacy of two pad-weighing test methods for evaluating pediatric urinary incontinence.
Main Methods:
- Thirty-three children (5-12 years) were evaluated, including 23 with incontinence and 10 controls.
- Two pad-weighing tests were employed: the standard 1-hour pad-weighing test and an inter-urination pad-weighing test.
- Voided urine volume and incontinence volume were measured, with an incontinence ratio calculated to account for age-related bladder capacity differences.
Main Results:
- Both tests correctly identified continent children.
- The 1-hour pad-weighing test detected incontinence in 9 of 23 children (loss 1-30g, ratio 0.5-14.8%).
- The inter-urination pad-weighing test detected incontinence in 11 of 23 children (loss 2-50g, ratio 1.5-80.6%).
Conclusions:
- No significant difference in incontinence incidence was found between the two tests.
- The inter-urination pad-weighing test demonstrated a closer correlation with clinical symptoms.
- This novel method may offer improved objective assessment of urinary incontinence in pediatric patients.
Objective:
To assess urinary incontinence objectively in children.
Patients And Methods:
Thirty-three children (mean age 8.2 years, range 5-12) were examined, of whom 23 suffered from incontinence and 10 did not. The first method of assessing incontinence was the 1-h pad-weighing test proposed by the International Continence Society in 1983 and the second was a test in which the pad was weighed between one urination and the next. At the end of the tests the volume of normally voided urine was measured and the total voided volume during the test calculated. The volume of urine lost during incontinence and the ratio [incontinence volume/(incontinence volume + voided volume)] were evaluated; the ratio was used because the bladder capacity in children differed with age.
Results:
In both tests, no wetting occurred in any of the 10 patients not complaining of incontinence. In the 1-h pad-weighing test, no wetting occurred in 14 of the 23 patients complaining of incontinence but did in the nine remaining patients, the loss being 1-30 g, and the incontinence ratio 0.5-14.8%. In the second test, no wetting occurred in 12 of the 23 patients complaining of incontinence but did so in the 11 remaining patients, with losses of 2-50 g and incontinence ratios of 1.5-80.6%.
Conclusions:
There was no significant difference between the tests in the incidence of incontinence. However, the second method seemed to be more closely related to the clinical symptoms than was the 1-h pad-weighing test and may be useful in the assessment of incontinence in children.