Tags

Type your tag names separated by a space and hit enter

Outcome of a standardized approach to childhood urinary symptoms-long-term follow-up of 720 patients.
Neurourol Urodyn. 2014 Jun; 33(5):475-81.NU

Abstract

AIMS

To investigate the relevance of enuresis subtyping for selection of treatment modality and for long-term outcome in a large consecutive patient cohort.

MATERIALS AND METHODS

We included all patients referred for urinary incontinence during a 5-year period but excluding recurrent urinary tract infections (UTI). Type and severity of incontinence, prior history, results of examinations performed, number of visits, and effect of all treatments provided, were included in a clinical database.

RESULTS

Seven hundred twenty children aged 4-16 years (mean 8.5 ± 2.2 years, 239 girls) were included in the analysis (42% with monosymptomatic (MNE), 55% with non-MNE, and 3% with isolated daytime incontinence). Initial evaluation revealed only few underlying causes (one neurological and eight anatomical). Investigations showed significant differences between MNE and non-MNE patients as both maximal voided volume and nocturnal urine volume was lower in non-MNE patients (P < 0.001). Follow-up for average 1,587 days (3.4 years) was performed in 660 (92%) patients. A higher number of visits and a longer treatment period were needed for non-MNE patients (on average 4.7 ± 2.8 visits) than MNE patients (3.1 ± 1.6 visits, P < 0.001). The most common treatment regimen that resulted in dryness in both MNE (40%) and non-MNE (36%) was the alarm system. Interestingly, of the 539 patients who initially were referred due to desmopressin resistance 177 (33%) of these were dry on desmopressin monotherapy.

CONCLUSIONS

The study indicated that MNE and non-MNE are two distinct disease entities with different optimal treatments and showed that the latter patients are more difficult and time-consuming to manage.

Authors+Show Affiliations

Department of Pediatrics, Aarhus University Hospital, Aarhus University, Aarhus, Denmark.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23765698

Citation

Rittig, Nikolaj, et al. "Outcome of a Standardized Approach to Childhood Urinary Symptoms-long-term Follow-up of 720 Patients." Neurourology and Urodynamics, vol. 33, no. 5, 2014, pp. 475-81.
Rittig N, Hagstroem S, Mahler B, et al. Outcome of a standardized approach to childhood urinary symptoms-long-term follow-up of 720 patients. Neurourol Urodyn. 2014;33(5):475-81.
Rittig, N., Hagstroem, S., Mahler, B., Kamperis, K., Siggaard, C., Mikkelsen, M. M., Bower, W. F., Djurhuus, J. C., & Rittig, S. (2014). Outcome of a standardized approach to childhood urinary symptoms-long-term follow-up of 720 patients. Neurourology and Urodynamics, 33(5), 475-81. https://doi.org/10.1002/nau.22447
Rittig N, et al. Outcome of a Standardized Approach to Childhood Urinary Symptoms-long-term Follow-up of 720 Patients. Neurourol Urodyn. 2014;33(5):475-81. PubMed PMID: 23765698.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome of a standardized approach to childhood urinary symptoms-long-term follow-up of 720 patients. AU - Rittig,Nikolaj, AU - Hagstroem,Søren, AU - Mahler,Birgitte, AU - Kamperis,Konstantinos, AU - Siggaard,Charlotte, AU - Mikkelsen,Mette Marie, AU - Bower,Wendy Fiona, AU - Djurhuus,Jens C, AU - Rittig,Søren, Y1 - 2013/06/14/ PY - 2012/12/25/received PY - 2013/05/15/accepted PY - 2013/6/15/entrez PY - 2013/6/15/pubmed PY - 2015/2/13/medline KW - daytime incontinence KW - nocturnal enuresis KW - outcome KW - treatment KW - ultrasound KW - uroflowmetry SP - 475 EP - 81 JF - Neurourology and urodynamics JO - Neurourol Urodyn VL - 33 IS - 5 N2 - AIMS: To investigate the relevance of enuresis subtyping for selection of treatment modality and for long-term outcome in a large consecutive patient cohort. MATERIALS AND METHODS: We included all patients referred for urinary incontinence during a 5-year period but excluding recurrent urinary tract infections (UTI). Type and severity of incontinence, prior history, results of examinations performed, number of visits, and effect of all treatments provided, were included in a clinical database. RESULTS: Seven hundred twenty children aged 4-16 years (mean 8.5 ± 2.2 years, 239 girls) were included in the analysis (42% with monosymptomatic (MNE), 55% with non-MNE, and 3% with isolated daytime incontinence). Initial evaluation revealed only few underlying causes (one neurological and eight anatomical). Investigations showed significant differences between MNE and non-MNE patients as both maximal voided volume and nocturnal urine volume was lower in non-MNE patients (P < 0.001). Follow-up for average 1,587 days (3.4 years) was performed in 660 (92%) patients. A higher number of visits and a longer treatment period were needed for non-MNE patients (on average 4.7 ± 2.8 visits) than MNE patients (3.1 ± 1.6 visits, P < 0.001). The most common treatment regimen that resulted in dryness in both MNE (40%) and non-MNE (36%) was the alarm system. Interestingly, of the 539 patients who initially were referred due to desmopressin resistance 177 (33%) of these were dry on desmopressin monotherapy. CONCLUSIONS: The study indicated that MNE and non-MNE are two distinct disease entities with different optimal treatments and showed that the latter patients are more difficult and time-consuming to manage. SN - 1520-6777 UR - https://www.unboundmedicine.com/medline/citation/23765698/Outcome_of_a_standardized_approach_to_childhood_urinary_symptoms_long_term_follow_up_of_720_patients_ L2 - https://doi.org/10.1002/nau.22447 DB - PRIME DP - Unbound Medicine ER -