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Prospective Evaluation of Clinical Voiding Re-Education or Voiding School for Lower Urinary Tract Conditions in Children
S68
ESPU Programme 2010
# S12-3 (PP) DEVELOPMENT OF THE SCORING SYSTEM ABOUT FUNCTIONAL VOIDING DYSFUNCTION IN PEDIATRIC POPULATION Ha Na LEE1, Minki BAEK1, Kyung Won KWAK2, Young-Suk LEE1, Kyung Hun PAIK3, Chang Hee HONG4 and Kwan Hyun PARK1 1
Sungkyunkwan University School of Medicine, Urology, Seoul, KOREA (REPUBLIC OF), 2Hanil General Hospital, Urology, Seoul, KOREA (REPUBLIC OF), 3Sungkyunkwan University School of Medicine, Department of Pediatrics, Seoul, KOREA (REPUBLIC OF), 4Yonsei University College of Medicine, Urology, Seoul, KOREA (REPUBLIC OF)
PURPOSE There have not been globally accepted and validated methods of quantitative evaluation of functional voiding dysfunction in children. We developed a validated questionnaire in Korean for the scoring system about functional voiding dysfunction.
general health examination without specific voiding symptom were included. The control group was matched with age and sex of the patients group. Any children with physical and neurological abnormalities were excluded. The same questionnaire was completed 1 week later to assess the testretest reliability.
RESULTS MATERIAL AND METHODS A questionnaire of 14-items was developed using a combination of literature review; and expert opinions. Twenty-nine children who were clinically diagnosed with functional voiding dysfunction and 21 children who visited Pediatric clinic for
Mean age of the participants was 7.6 years old(7.62.4 vs 7.63.6, p¼0.538). A total 10 items were satisfied with discriminative validity of questionnaire item between the patients and controls excluding 4 items of frequency, pain, nocturnal frequency, and bowel habits. Internal consistency of
questionnaire items was concluded that the value of Cronbach’s alpha was 0.818. All items showed good stability by assessment test-retest reliability except one item of urinary incontinence which showed marginal stability. According to inter-item correlation analysis, most items were significantly correlated with other items. A ROC curve was generated to determine the optimal cutoff score to diagnose functional voiding problem. A total score of 7 was associated with 93% sensitivity and 95% specificity.
CONCLUSIONS This newly developed scoring system was a reliable and valid tool for diagnosing functional voiding dysfunction in children.
# S12-4 (PP) PROSPECTIVE EVALUATION OF CLINICAL VOIDING RE-EDUCATION OR VOIDING SCHOOL FOR LOWER URINARY TRACT CONDITIONS IN CHILDREN Piet HOEBEKE1, Lynn DE SCHRIJVER1, Ellen LEENAERTS1, Alien SCHOENAERS1, Catherine RENSON1, Johan VANDE WALLE2 and Chris VAN DEN BROECK3 1 Ghent University Hospital, Urology, Gent, BELGIUM, 2Ghent University Hospital, Paediatrics, Gent, BELGIUM, 3Ghent University, Rehabilitation Sciences and Physiotherapy, Gent, BELGIUM
PURPOSE Prospective controlled study evaluating the results of a clinical voiding re-education programme or voiding school (VS) for treatment of lower urinary tract conditions (LUT) in children compared to no treatment.
MATERIAL AND METHODS Thirty eight children with non neurogenic LUT conditions, resistant to out patient urotherapy, were included in a study protocol evaluating the effect of a clinical or in patient voiding re-education programme or urotherapy. Sixteen children on the waiting list for the same programme were included as control receiving no treatment while on the waiting list. The clinical voiding re-education programme consisted in
instructions on voiding and drinking, individualised voiding diaries, pelvic floor biofeedback training, uroflowmetry, cognitive therapy and psychological support. Data on voiding, drinking, pelvic floor control, voided volume, uroflow, incontinence and stool habits were gathered before the programme, during the programme and 6 months after the programme. In the control group the same data were gathered when they were put on the waiting list and 6 months later.
RESULTS In the study group a positive effect of the VS was observed in 92% of children. Forty two% became completely dry, 24% changed from incontinence during day and night to incontinence day or night only while in 26%
incontinence remained but in all patients the number of incontinence periods and the amount decreased. In the control group no differences were observed between intake and 6 months later. The study group did significantly better on voided volume and incontinence compared to the control group.
CONCLUSIONS In this prospective controlled study a positive effect on voided volume and on incontinence with a clinical voiding reeducation programme or voiding school is reported. This is the first prospective controlled study on the effects of urotherapy.
ESPU Programme 2010
# S12-3 (PP) DEVELOPMENT OF THE SCORING SYSTEM ABOUT FUNCTIONAL VOIDING DYSFUNCTION IN PEDIATRIC POPULATION Ha Na LEE1, Minki BAEK1, Kyung Won KWAK2, Young-Suk LEE1, Kyung Hun PAIK3, Chang Hee HONG4 and Kwan Hyun PARK1 1
Sungkyunkwan University School of Medicine, Urology, Seoul, KOREA (REPUBLIC OF), 2Hanil General Hospital, Urology, Seoul, KOREA (REPUBLIC OF), 3Sungkyunkwan University School of Medicine, Department of Pediatrics, Seoul, KOREA (REPUBLIC OF), 4Yonsei University College of Medicine, Urology, Seoul, KOREA (REPUBLIC OF)
PURPOSE There have not been globally accepted and validated methods of quantitative evaluation of functional voiding dysfunction in children. We developed a validated questionnaire in Korean for the scoring system about functional voiding dysfunction.
general health examination without specific voiding symptom were included. The control group was matched with age and sex of the patients group. Any children with physical and neurological abnormalities were excluded. The same questionnaire was completed 1 week later to assess the testretest reliability.
RESULTS MATERIAL AND METHODS A questionnaire of 14-items was developed using a combination of literature review; and expert opinions. Twenty-nine children who were clinically diagnosed with functional voiding dysfunction and 21 children who visited Pediatric clinic for
Mean age of the participants was 7.6 years old(7.62.4 vs 7.63.6, p¼0.538). A total 10 items were satisfied with discriminative validity of questionnaire item between the patients and controls excluding 4 items of frequency, pain, nocturnal frequency, and bowel habits. Internal consistency of
questionnaire items was concluded that the value of Cronbach’s alpha was 0.818. All items showed good stability by assessment test-retest reliability except one item of urinary incontinence which showed marginal stability. According to inter-item correlation analysis, most items were significantly correlated with other items. A ROC curve was generated to determine the optimal cutoff score to diagnose functional voiding problem. A total score of 7 was associated with 93% sensitivity and 95% specificity.
CONCLUSIONS This newly developed scoring system was a reliable and valid tool for diagnosing functional voiding dysfunction in children.
# S12-4 (PP) PROSPECTIVE EVALUATION OF CLINICAL VOIDING RE-EDUCATION OR VOIDING SCHOOL FOR LOWER URINARY TRACT CONDITIONS IN CHILDREN Piet HOEBEKE1, Lynn DE SCHRIJVER1, Ellen LEENAERTS1, Alien SCHOENAERS1, Catherine RENSON1, Johan VANDE WALLE2 and Chris VAN DEN BROECK3 1 Ghent University Hospital, Urology, Gent, BELGIUM, 2Ghent University Hospital, Paediatrics, Gent, BELGIUM, 3Ghent University, Rehabilitation Sciences and Physiotherapy, Gent, BELGIUM
PURPOSE Prospective controlled study evaluating the results of a clinical voiding re-education programme or voiding school (VS) for treatment of lower urinary tract conditions (LUT) in children compared to no treatment.
MATERIAL AND METHODS Thirty eight children with non neurogenic LUT conditions, resistant to out patient urotherapy, were included in a study protocol evaluating the effect of a clinical or in patient voiding re-education programme or urotherapy. Sixteen children on the waiting list for the same programme were included as control receiving no treatment while on the waiting list. The clinical voiding re-education programme consisted in
instructions on voiding and drinking, individualised voiding diaries, pelvic floor biofeedback training, uroflowmetry, cognitive therapy and psychological support. Data on voiding, drinking, pelvic floor control, voided volume, uroflow, incontinence and stool habits were gathered before the programme, during the programme and 6 months after the programme. In the control group the same data were gathered when they were put on the waiting list and 6 months later.
RESULTS In the study group a positive effect of the VS was observed in 92% of children. Forty two% became completely dry, 24% changed from incontinence during day and night to incontinence day or night only while in 26%
incontinence remained but in all patients the number of incontinence periods and the amount decreased. In the control group no differences were observed between intake and 6 months later. The study group did significantly better on voided volume and incontinence compared to the control group.
CONCLUSIONS In this prospective controlled study a positive effect on voided volume and on incontinence with a clinical voiding reeducation programme or voiding school is reported. This is the first prospective controlled study on the effects of urotherapy.