1.1 Introduction & Urotherapy a profession / Lecture online
Introduction
The urotherapy certification program has two primary goals. The first goal is to enhance knowledge and improve the quality of care for children with lower urinary tract dysfunction and constipation. The second goal is to provide healthcare professionals—trainees, nurses, physiotherapists, and psychologists—with in-depth medical, nursing, and behavioral theoretical knowledge, enriching their existing backgrounds to ensure comprehensive coverage of all relevant aspects of urotherapy.
Additionally, the program aims to position the urotherapist as a professional practitioner with defined roles towards children, parents/caregivers, colleagues, and medical professionals. This program aspires to go beyond merely understanding the clinical picture. It aims to empower urotherapists to establish themselves as key professionals in the care of children with functional micturition and defecation issues, such as incontinence, within the healthcare landscape. The ultimate goal is to develop urotherapy into an evidence-based specialization. Therefore, more scientifically educated urotherapists and continuous education for urotherapists are essential. Besides educating specialized professionals like urotherapists, enhancing knowledge about incontinence in both the general population and among professionals working with children is important.
Learning objectives
The participant:
- Has knowledge of the history or urotherapy
- develops an in-depth understanding of the medical, nursing and behavioural principles relevant to urotherapy and is able to integrate these concepts into practical applications.
- Knows how the urotherapist can work within an interdisciplinary setting
Literature
- Nieuwhof-Leppink AJ, Hussong J, Chase J, Larsson J, Renson C, Hoebeke P, Yang S, von Gontard A. Definitions, indications and practice of urotherapy in children and adolescents: - A standardization document of the International Children's Continence Society (ICCS). J Pediatr Urol. 2021 Apr;17(2):172-181. doi: 10.1016/j.jpurol.2020.11.006. Epub 2020 Nov 5. PMID: 33478902.
1.2 Anatomy/physiology bowel system & definitions and assessment of bowel problems/ Lecture online
Introduction
This study activity is a part of basic knowledge. To properly treat the child with bladder and bowel problems, it is crucial to have knowledge about the anatomy of the intestinal system. How does the system work and what is the interplay and involvement of the central nervous system. Knowledge of dysfunction and associated definitions are essential to making a correct diagnosis.
Learning objectives
The participant:
- Can name and explain the anatomy and physiology of the digestive tract
- Can explain and name the function of the pelvic floor muscles.
- Can explain what happens during filling and emptying of the rectum
- Has an understanding of the pathophysiology of constipation and fecal incontinence in children
Literature
Book: Pediatric incontinence - evaluation and clinical management:
Section 1, chapter 2, Neurophysiology of defecation.
Section 3, chapter 11, Evaluation of constipation and fecal incontinence ,
Recommended literature
- Yang S, Chua ME, Bauer S, Wright A, Brandström P, Hoebeke P, Rittig S, De Gennaro M, Jackson E, Fonseca E, Nieuwhof-Leppink A, Austin P. Diagnosis and management of bladder bowel dysfunction in children with urinary tract infections: a position statement from the International Children's Continence Society. Pediatr Nephrol. 2018 Dec;33(12):2207-2219. doi: 10.1007/s00467-017-3799-9. Epub 2017 Oct 3. PMID: 28975420.
1.3 Assessment & management of functional bowel problems/ Lecture online
Introduction
During this course activity, the drug treatment of constipation/feces incontinence will be discussed. The cause of defecation problems is complex; it often involves a combination of physical, psychological and social factors. It ise ssential is that treatment has multidisciplinary approach. First choice treatment of constipation/feces incontinence consists of education, lifestyle advice and toilet training .
Learning objectives
The participant:
- Has knowledge of terminology regarding constipation and fecal incontinence in children
- Has knowledge of the diagnosis of functional constipation
- Can name and apply the Rome-IV criteria
- Has knowledge of therpeutic possibilities of functional constipation and fecal incontinence
- Has knowledge of the role of complementary examination in obstipation and fecal incontinence
- Knows the drug treatment of constipation in children
- Has knowledge of dicipline-specific therapies of the multidicplinary treatment team of constipation
Literature
Book: pediatric incontinence evaluation and clinical management:
1. Section 1; chapter 2; Neurophysiology of defecation
2. Section 3; chapter 11; Evaluation of constipation and fecal incontinence
Recommended literature
Yang S, Chua ME, Bauer S, Wright A, Brandström P, Hoebeke P, Rittig S, De Gennaro M, Jackson E, Fonseca E, Nieuwhof-Leppink A, Austin P. Diagnosis and management of bladder bowel dysfunction in children with urinary tract infections: a position statement from the International Children's Continence Society. Pediatr Nephrol. 2018 Dec;33(12):2207-2219. doi: 10.1007/s00467-017-3799-9. Epub 2017 Oct 3. PMID: 28975420.
Vriesman MH, Koppen IJN, Camilleri M, Di Lorenzo C, Benninga MA. Management of functional constipation in children and adults. Nat Rev Gastroenterol Hepatol. 2020 Jan;17(1):21-39. doi: 10.1038/s41575-019-0222-y. Epub 2019 Nov 5. PMID: 31690829.
Koppen IJ, von Gontard A, Chase J, Cooper CS, Rittig CS, Bauer SB, Homsy Y, Yang SS, Benninga MA. Management of functional nonretentive fecal incontinence in children: Recommendations from the International Children's Continence Society. J Pediatr Urol. 2016 Feb;12(1):56-64. doi: 10.1016/j.jpurol.2015.09.008. Epub 2015 Oct 21. PMID: 26654481.
1.4 Q&A Discussion/ Live session online
During this online session you will have the opportunity to ask questions based on the lectures you have attended.
