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The Long-Term Effects of Luts Treatment in Children
ESPU Programme 2008 improvement in symptoms or residual volumes.
S51 CONCLUSIONS Doxazosin resulted in complete resolution of symptoms in only 4/19(20%) of children while 33% had no improvement. Parents should be informed about the realistic
prognosis of this treatment option as in this study the ‘success’ rate was much lower than previously published.
From 13:56 to 14:01 # S10-4 (O) THE LONG-TERM EFFECTS OF LUTS TREATMENT IN CHILDREN Marianne A.w. VIJVERBERG, Eva STORTELDER*, Leatitia M.o. DE KORTy, Tom P.v.m. DE JONGz UMCUtrecht, Medical Psychology for Children, Utrecht, NETHERLANDS - *UMCUtrecht, Faculty of Medicine Utrecht, Utrecht, NETHERLANDS - yUMCUtrecht, Urology, Utrecht, NETHERLANDS - zUMCUtrecht, pediatric urology, Utrecht, NETHERLANDS
PURPOSE To compare the effect of urotherapy in children, 17.9 years after in-patient training, with published data at 6 months follow-up, and to assess the long-term development of paediatric LUTS.
MATERIAL AND METHODS Between 1987 and 1990, 95 children (13 male, 82 female)underwent urotherapy to treat functional LUTS. This group was traced and were given a questionnaire in order to determine the long-term effect of the training programme. A selected group agreed to come to the hospital for
uroflowmetry and bladder ultrasound after micturation.
RESULTS Of all 95 patients, 92 were localized and a cohort of 75 could be analysed, with a mean follow-up of 17.9 years. Initially, at six months, 72% had showed good results, which dropped to 57.4% at 17.9 years, which means that 14.6% had relapsed. Of the 75 patients, 60% was free of complaints at long-term follow up. At 6 months, 28% had been unsuccessful, and this dropped to 8% as a result of spontaneous recovery. In short, of 54 patients who had initially shown good
results, 11 relapsed, and of 21 patients with an initial bad result, 14 had a spontaneous recovery. Over the previous 6 months, urinary tract infections were reported in 32.0% and constipation in 24.0%. Overall, 62.7% experienced the urotherapy as useful.
CONCLUSIONS Urotherapy for therapy resistant functional LUTS had a good long-term result in more than half the cases. Young adults experience a surprisingly high number of complaints of the urinary tract, even after intensive therapy at a young age.
From 14:01 to 14:06 # S10-5 (O) TEAM: A NATIONAL, MULTICENTRIC, RETROSPECTIVE ANALYSIS OF OUTCOMES IN NOCTURNAL ENURETIC CHILDREN TREATED WITH AN ANTIDIURETIC IN TWO DIFFERENT MODES ¨ NEMANNy Daniela MARSCHALL-KEHREL, Diana DEVEY*, Klaus-peter JU Praxis fu¨r Urologie, Frankfurt, GERMANY - *FERRING Arzneimittel GmbH, Medical Department, Kiel, GERMANY - yUniversita¨tsklinikum SH-Kiel, Urologie und Kinderurologie, Kiel, GERMANY
PURPOSE Several monocentre authors described an improvement in outcome of desmopressin treatment when not terminated abruptly but instead tapered out. This national multicentre retrospective survey was designed to test whether structured withdrawal of desmopressin can improve outcome.
distribution. 267 patients were pre-treated. At outset, 41% showed 7 wet nights/week, 45% showed 3-6 and 14% <3. All patients were treated with desmopressin. Response to therapy was subdivided into response (wet nights reduction >90%), partial response (50-90%) and minor reduction (<50%). After 4-26 weeks treatment was either abruptly terminated or tapered. Relief of bedwetting was defined as <2 wet nights/month.
MATERIAL AND METHODS RESULTS 487 enuretic patients from 181 centres were enrolled. The study was conducted on outpatients with typical age and gender
The group with abrupt termination (173 children) showed 51% response, 27% partial
response and 22% minor reduction. The tapering group (314 children) had 72% response, 24% partial response and 4% minor reduction (p<0.0001). Enuresis frequency with abrupt termination decreased from 20.53 wet nights/month before treatment to 5.8. The tapering group had 21 wet nights/ months before and 1.86 after (p<0.0001). One month follow up showed <2 wet nights/ month in 57% with abrupt termination and in 80% with tapering (p<0.0001). Pretreatment had no influence. No severe side effects occurred.
S51 CONCLUSIONS Doxazosin resulted in complete resolution of symptoms in only 4/19(20%) of children while 33% had no improvement. Parents should be informed about the realistic
prognosis of this treatment option as in this study the ‘success’ rate was much lower than previously published.
From 13:56 to 14:01 # S10-4 (O) THE LONG-TERM EFFECTS OF LUTS TREATMENT IN CHILDREN Marianne A.w. VIJVERBERG, Eva STORTELDER*, Leatitia M.o. DE KORTy, Tom P.v.m. DE JONGz UMCUtrecht, Medical Psychology for Children, Utrecht, NETHERLANDS - *UMCUtrecht, Faculty of Medicine Utrecht, Utrecht, NETHERLANDS - yUMCUtrecht, Urology, Utrecht, NETHERLANDS - zUMCUtrecht, pediatric urology, Utrecht, NETHERLANDS
PURPOSE To compare the effect of urotherapy in children, 17.9 years after in-patient training, with published data at 6 months follow-up, and to assess the long-term development of paediatric LUTS.
MATERIAL AND METHODS Between 1987 and 1990, 95 children (13 male, 82 female)underwent urotherapy to treat functional LUTS. This group was traced and were given a questionnaire in order to determine the long-term effect of the training programme. A selected group agreed to come to the hospital for
uroflowmetry and bladder ultrasound after micturation.
RESULTS Of all 95 patients, 92 were localized and a cohort of 75 could be analysed, with a mean follow-up of 17.9 years. Initially, at six months, 72% had showed good results, which dropped to 57.4% at 17.9 years, which means that 14.6% had relapsed. Of the 75 patients, 60% was free of complaints at long-term follow up. At 6 months, 28% had been unsuccessful, and this dropped to 8% as a result of spontaneous recovery. In short, of 54 patients who had initially shown good
results, 11 relapsed, and of 21 patients with an initial bad result, 14 had a spontaneous recovery. Over the previous 6 months, urinary tract infections were reported in 32.0% and constipation in 24.0%. Overall, 62.7% experienced the urotherapy as useful.
CONCLUSIONS Urotherapy for therapy resistant functional LUTS had a good long-term result in more than half the cases. Young adults experience a surprisingly high number of complaints of the urinary tract, even after intensive therapy at a young age.
From 14:01 to 14:06 # S10-5 (O) TEAM: A NATIONAL, MULTICENTRIC, RETROSPECTIVE ANALYSIS OF OUTCOMES IN NOCTURNAL ENURETIC CHILDREN TREATED WITH AN ANTIDIURETIC IN TWO DIFFERENT MODES ¨ NEMANNy Daniela MARSCHALL-KEHREL, Diana DEVEY*, Klaus-peter JU Praxis fu¨r Urologie, Frankfurt, GERMANY - *FERRING Arzneimittel GmbH, Medical Department, Kiel, GERMANY - yUniversita¨tsklinikum SH-Kiel, Urologie und Kinderurologie, Kiel, GERMANY
PURPOSE Several monocentre authors described an improvement in outcome of desmopressin treatment when not terminated abruptly but instead tapered out. This national multicentre retrospective survey was designed to test whether structured withdrawal of desmopressin can improve outcome.
distribution. 267 patients were pre-treated. At outset, 41% showed 7 wet nights/week, 45% showed 3-6 and 14% <3. All patients were treated with desmopressin. Response to therapy was subdivided into response (wet nights reduction >90%), partial response (50-90%) and minor reduction (<50%). After 4-26 weeks treatment was either abruptly terminated or tapered. Relief of bedwetting was defined as <2 wet nights/month.
MATERIAL AND METHODS RESULTS 487 enuretic patients from 181 centres were enrolled. The study was conducted on outpatients with typical age and gender
The group with abrupt termination (173 children) showed 51% response, 27% partial
response and 22% minor reduction. The tapering group (314 children) had 72% response, 24% partial response and 4% minor reduction (p<0.0001). Enuresis frequency with abrupt termination decreased from 20.53 wet nights/month before treatment to 5.8. The tapering group had 21 wet nights/ months before and 1.86 after (p<0.0001). One month follow up showed <2 wet nights/ month in 57% with abrupt termination and in 80% with tapering (p<0.0001). Pretreatment had no influence. No severe side effects occurred.