Bladder and bowel dysfunction and the resolution of urinary incontinence with successful management of bowel symptoms in children.
OBJECTIVE
To investigate the effect of treating defecation problems on urinary incontinence in children suffering from combined urinary bladder and bowel dysfunction (BBD).


METHODS
We established a clinical database from medical records of all children referred to the urinary incontinence and gastroenterology outpatient clinics with BBD. The following variables were extracted: symptoms of constipation, faecal incontinence, urinary incontinence, age at onset of symptoms, treatment, including duration and response. All children went through the same treatment protocol. Faecal disorders were treated primarily and once relieved, the daytime incontinence was managed and followed by intervention for nocturnal enuresis.


RESULTS
In total, 73 children were included in the study. The treatment regimen resulted in resolution of the defecation disorder in 96% of the patients. Of the children with daytime urinary incontinence, 68% had at least a 50% reduction in number of daytime incontinence episodes by successful relief of bowel dysfunction and 27% became completely continent during daytime. Only 17% of the children suffering from enuresis had a significant reduction in number of wet nights after relief of their faecal problem.


CONCLUSIONS
The empirical treatment approach of managing bowel symptoms before intervening for bladder dysfunction in children with BBD is found to be appropriate.
Department of Pediatrics, Aarhus University Hospital, Skejby, Aarhus, Denmark. lborch@live.dk
Luise
L
Borch
Søren
S
Hagstroem
Wendy F
WF
Bower
Charlotte
C
Siggaard Rittig
Søren
S
Rittig
D002648:Child; D002675:Child, Preschool; D003672:Defecation; D019960:Elimination Disorders / Q000628:therapy*; D005242:Fecal Incontinence / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D014549:Urinary Incontinence / Q000150:complications / Q000628:therapy*