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Correlation Of Uroflowmetry Parameters And Treatment Outcome In Children With Dysfunctional Voiding
ESPUN Programme 2009 improvement in continence was reflected in QoL score for most children. Weekly
S101 treatments impact on family life and some families had difficulties meeting this
commitment. Long term outcome data collection is in progress.
# S03-7 (O) CHILDREN’S EXPERIENCES OF RULES FOR TOILET VISITS IN SCHOOL ¨ M2 Barbro LUNDBLAD1 and Anna-Lena HELLSTRO 1
Sahlgrenska Academy, Inst of health and caring sciences, Goteborg, SWEDEN, 2Queen Silvia Children´s Hsp, Goteborg, SWEDEN
PURPOSE
RESULTS
Introduction: Except for the impressions of sight and smell in the school toilets, anxiety is the most reported explanation for avoidance behavior. To comply with treatment instructions, children with functional bladder disturbances have to visit the toilet regularly every 2 - 3 h. In interviews children said they found it difficult to comply with treatment during school time. Aim: To describe children’s experiences of school rules for toilet visits.
Results: Structuring rules were commonly used by teachers to handle pupils’ toilet needs. The attitude in schools was that toilet visits should be carried out during breaks. The children’s overall attitude was that a need to go to the toilet was a private matter. A lot of children found it difficult to visit the toilet during break depending on shortage of time. Due to the fact that during breaks a lot of schoolmates were outside the toilets they calculated the risk of being exposed during the toilet visit as high. Many children therefore preferred going during class. To get permission children had to raise their hand and in front of all declare their private need. If the teacher found it
MATERIAL AND METHODS Method: Open ended interviews with 19 school children aged 9-16.
suitable the children got permission to satisfy their toilet need.
CONCLUSIONS Conclusion: From a health perspective not being allowed to go to toilet when needed seems precarious for all school children and in particular for those who have bladder disturbances. To ignore the integrity of children affects their wellbeing during school time.
# S03-8 (P) CORRELATION OF UROFLOWMETRY PARAMETERS AND TREATMENT OUTCOME IN CHILDREN WITH DYSFUNCTIONAL VOIDING Vesna ZIVKOVIC1, Milica LAZOVIC2, Marina VLAJKOVIC3, Andjelka SLAVKOVIC4 and Lidija DIMITRIJEVIC2 1 Clinic for physical medicine and rehabilitation, pediatric department, Nis, YUGOSLAVIA, 2Clinic of physical medicine and rehabilitation, Nis, YUGOSLAVIA, 3Center for nuclear medicine, Nis, YUGOSLAVIA, 4Clinic for pediatric surgery, Nis, YUGOSLAVIA
PURPOSE Aim of the study was to investigate the correlation between treatment outcome in urinary incontinence, nocturnal enuresis and urinary tract infections (UTIs) and uroflowmetry parameters in children with dysfunctional voiding.
MATERIAL AND METHODS Seventy five children, mean age 7,1 2,5 years, unimproved by previous therapies, were randomly divided into two groups. Group A was submitted to 6,5 (range 4-14) sessions of urotherapy that consisted of timed voiding, hydratation, optimal posture during voiding and pelvic floor exercises. Group B received conservative treatment
including timed voiding and hydratation. Constipation and recurrent UTIs were treated in both groups. Uroflowmetry with EMG of the pelvic floor and ultrasound residual urine (RU) volumes were obtained before and at the end of the 12-month treatment period. Uroflowmetry findings were stratified into two categories based on response to therapy: ’’cured‘‘ (group of children in whom urinary incontinence, nocturnal enuresis and UTIs were cured) and ’’no change‘‘ . Uroflowmetry findings were compared between categories at the beginning and the end of the investigation.
RESULTS There was no significant difference for any of the uroflowmetry parameters at the
beginning of the study. After one year of therapy VV, AFR and PFR were significantly increased while RU was significantly decreased in children with cured urinary incontinence and nocturnal enuresis compared with ’’no change‘‘ category. Significant decrease of RU was noted in children with cured UTIs.
CONCLUSIONS Posttreatment improvement in clinical symptoms correlate with improvement in uroflowmetry parameters. Improvement of voiding phase is necessary for urinary continence achievement and resolution of UTIs.
S101 treatments impact on family life and some families had difficulties meeting this
commitment. Long term outcome data collection is in progress.
# S03-7 (O) CHILDREN’S EXPERIENCES OF RULES FOR TOILET VISITS IN SCHOOL ¨ M2 Barbro LUNDBLAD1 and Anna-Lena HELLSTRO 1
Sahlgrenska Academy, Inst of health and caring sciences, Goteborg, SWEDEN, 2Queen Silvia Children´s Hsp, Goteborg, SWEDEN
PURPOSE
RESULTS
Introduction: Except for the impressions of sight and smell in the school toilets, anxiety is the most reported explanation for avoidance behavior. To comply with treatment instructions, children with functional bladder disturbances have to visit the toilet regularly every 2 - 3 h. In interviews children said they found it difficult to comply with treatment during school time. Aim: To describe children’s experiences of school rules for toilet visits.
Results: Structuring rules were commonly used by teachers to handle pupils’ toilet needs. The attitude in schools was that toilet visits should be carried out during breaks. The children’s overall attitude was that a need to go to the toilet was a private matter. A lot of children found it difficult to visit the toilet during break depending on shortage of time. Due to the fact that during breaks a lot of schoolmates were outside the toilets they calculated the risk of being exposed during the toilet visit as high. Many children therefore preferred going during class. To get permission children had to raise their hand and in front of all declare their private need. If the teacher found it
MATERIAL AND METHODS Method: Open ended interviews with 19 school children aged 9-16.
suitable the children got permission to satisfy their toilet need.
CONCLUSIONS Conclusion: From a health perspective not being allowed to go to toilet when needed seems precarious for all school children and in particular for those who have bladder disturbances. To ignore the integrity of children affects their wellbeing during school time.
# S03-8 (P) CORRELATION OF UROFLOWMETRY PARAMETERS AND TREATMENT OUTCOME IN CHILDREN WITH DYSFUNCTIONAL VOIDING Vesna ZIVKOVIC1, Milica LAZOVIC2, Marina VLAJKOVIC3, Andjelka SLAVKOVIC4 and Lidija DIMITRIJEVIC2 1 Clinic for physical medicine and rehabilitation, pediatric department, Nis, YUGOSLAVIA, 2Clinic of physical medicine and rehabilitation, Nis, YUGOSLAVIA, 3Center for nuclear medicine, Nis, YUGOSLAVIA, 4Clinic for pediatric surgery, Nis, YUGOSLAVIA
PURPOSE Aim of the study was to investigate the correlation between treatment outcome in urinary incontinence, nocturnal enuresis and urinary tract infections (UTIs) and uroflowmetry parameters in children with dysfunctional voiding.
MATERIAL AND METHODS Seventy five children, mean age 7,1 2,5 years, unimproved by previous therapies, were randomly divided into two groups. Group A was submitted to 6,5 (range 4-14) sessions of urotherapy that consisted of timed voiding, hydratation, optimal posture during voiding and pelvic floor exercises. Group B received conservative treatment
including timed voiding and hydratation. Constipation and recurrent UTIs were treated in both groups. Uroflowmetry with EMG of the pelvic floor and ultrasound residual urine (RU) volumes were obtained before and at the end of the 12-month treatment period. Uroflowmetry findings were stratified into two categories based on response to therapy: ’’cured‘‘ (group of children in whom urinary incontinence, nocturnal enuresis and UTIs were cured) and ’’no change‘‘ . Uroflowmetry findings were compared between categories at the beginning and the end of the investigation.
RESULTS There was no significant difference for any of the uroflowmetry parameters at the
beginning of the study. After one year of therapy VV, AFR and PFR were significantly increased while RU was significantly decreased in children with cured urinary incontinence and nocturnal enuresis compared with ’’no change‘‘ category. Significant decrease of RU was noted in children with cured UTIs.
CONCLUSIONS Posttreatment improvement in clinical symptoms correlate with improvement in uroflowmetry parameters. Improvement of voiding phase is necessary for urinary continence achievement and resolution of UTIs.