Treatment outcome of day-time urinary incontinence in children.
OBJECTIVE
To analyse retrospectively the efficacy of day-time incontinence treatment in a secondary referral centre and consider characteristics of responders to the different therapeutic interventions.


METHODS
All children treated for day-time urinary incontinence at the authors' clinics from 2000 to 2004 were included. Children with ongoing urinary tract infections were excluded. Before treatment, children filled out registrations of incontinence episodes and 48h frequency-volume charts. Faecal disorders were treated before urinary incontinence. All children were subjected to standard urotherapy and were secondarily recommended a timer-watch. If standard urotherapy had no effect, anticholinergics were added.


RESULTS
The study included 240 children with day-time urinary incontinence. Of these, 45 had faecal problems and 17% obtained urinary continence when these were successfully treated. In total, 126 (55%) became dry on standard urotherapy. Of the 60 children who had a timer-watch in addition to standard urotherapy, 70% became dry. Of the 62 children who had anticholinergics in addition to standard urotherapy, 81% became continent. Fifteen (6%) did not achieve continence and another 11 patients were lost to follow-up. Children who became dry solely on standard urotherapy had a significantly lower voiding frequency (p<0.05), larger voided volumes as a percentage of those expected for age (p<0.01) and fewer incontinence episodes per week (p<0.05) than children needing anticholinergics.


CONCLUSIONS
Most children achieve day-time continence solely on standard urotherapy. Children who need anticholinergics to achieve dryness seem to be those with more severe bladder reservoir function abnormalities and symptoms.
Hagstroem
Søren
S
Clinical Institute, University of Aarhus, Denmark. hagstroem@ki.au.dk
Rittig
Nikolaj
N
Kamperis
Konstantinos
K
Mikkelsen
Mette Marie
MM
Rittig
Søren
S
Djurhuus
Jens Christian
JC
D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D053207:Diurnal Enuresis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008333:Mandelic Acids / Q000627:therapeutic use*; D010276:Parasympatholytics / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014563:Urodynamics / Q000502:physiology
D008333:Mandelic Acids; D010276:Parasympatholytics; C005419:oxybutynin