Prospective evaluation of inpatient and outpatient bladder training in children with functional urinary incontinence.
OBJECTIVE
To evaluate, in a prospective study, the effectiveness of a bladder training program. Daytime and/or nighttime wetting as a consequence of functional urinary incontinence is a common problem in childhood. Various treatment options are available, including with cognitive-behavioral "bladder training."


METHODS
Sixty patients (age 8 to 12 years) with urge incontinence or dysfunctional voiding were evaluated. After a no-treatment control period (average 6 months), patients underwent a 6-day bladder training course, which was offered either as inpatient or outpatient training, leaving the choice to the patients' parents. Clinical assessments were recorded at the beginning of the control period, at training entry and training completion, and after 1 (inpatient training group only), 3, and 6 months.


RESULTS
Six months after training completion, 64.1% and 64.7% of the inpatient and outpatient groups with daytime wetting and 51.5% and 17.7% of the inpatient and outpatient groups with nighttime wetting were cured or had improved, respectively. The spontaneous cure rate during the 6-month control period was 0% to 20.5%. Of the inpatient group with urge incontinence, the functional bladder capacity increased by 15%. The children aged 9 to 12 years in the inpatient group had significantly greater cure rates than the 8-year-old children.


CONCLUSIONS
Compared with the control period, the bladder training program evaluated in this study resulted in significantly greater success rates. The results lead to the assumption that children with nighttime wetting treated in the inpatient training will succeed better than those in outpatient training. The cure and improvement rates of daytime wetting were greater than those for nighttime wetting.
Heilenkötter
Kathrin
K
Department of Pediatrics, Klinikum Links der Weser, Bremen, Germany.
Bachmann
Christian
C
Janhsen
Ellen
E
Stauber
Tatiana
T
Lax
Hildegard
H
Petermann
Franz
F
Bachmann
Hannsjörg
H
D000553:Ambulatory Care; D002648:Child; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D011446:Prospective Studies; D014549:Urinary Incontinence / Q000628:therapy*