ESPU Congress 2018 - Abstract Book

220

CONGRESS OF THE ESPU

10:20–10:30

S1-5 (LO)

EXPLORING THE QUALITY OF TREATMENT FOR CHILDREN

WITH DAYTIME INCONTINENCE

Anka NIEUWHOF-LEPPINK

, Paul VAN LEUTEREN

, Aart KLIJN

Tom DE JONG

and Renkse SCHAPPIN

1) University Children's Hospitals, UMC Utrecht and AMC Amsterdam, Pediatric urology, psychology & social work,

Utrecht, NETHERLANDS - 2) University Children's Hospitals UMC Utrecht and AMC Amsterdam, Pediatric urology,

Utrecht, NETHERLANDS - 3) Wilhelmina Children's Hospital, University Medical Center Utrecht (UMCU), Psychology &

social work, Utrecht, NETHERLANDS

PURPOSE

Prevalence of daytime incontinence in school-aged children is 6–9 %. Nonetheless, it is difficult to

correctly diagnose and treat these children due to the subtle differences in symptoms. In a tertiary

care center, an exact diagnosis is crucial. In this study, we aim is to gain insight in the quality of care

for children with daytime incontinence in a tertiary reference center. Furthermore, we will determine

which factors influence the treatment trajectory.

MATERIAL AND METHODS

We performed a retrospective medical record review on a cohort who were referred to pediatric urol-

ogy for daytime incontinence. For each child a diagnostic and treatment trajectory was constructed

running from the first clinic visit to the end of the third-line treatment.

RESULTS

Of 123 children with a mean age of 7.6 years [66.7 % boys, 33.3 % girls], 63 % had unsuccessful

urotherapy elsewhere. Clinical diagnosis was defined in OAB (66 %), DV (25 %), PP (6 %), and

HAB (3 %). (Video) urodynamic investigation was done in 55 % and cystoscopy in 87 %. In 69 % of

referred children, a urinary tract obstruction was found while only 33 % of the children were referred

for obstruction. Intensive urotherapy was needed in 58 % of children. By now, 67 % of children

have completed all treatments, 54 % is completely dry and 34 % is improved. Average treatment

trajectory was 22 months.

CONCLUSIONS

Most children referred to a tertiary pediatric urologist for daytime incontinence become completely

dry or achieve partial improvement of their complaints, despite earlier unsuccessful treatment. In

half of the children a urethral anomaly was missed by the referring physician. Many referred children

received urotherapy elsewhere at too young age, making it unsuccessful.