ESPU Congress 2018 - Abstract Book

220 29 th CONGRESS OF THE ESPU 10:20–10:30 S1-5 (LO) EXPLORING THE QUALITY OF TREATMENT FOR CHILDREN WITH DAYTIME INCONTINENCE Anka NIEUWHOF-LEPPINK  1 , Paul VAN LEUTEREN  2 , Aart KLIJN  2 , Tom DE JONG  2 and Renkse SCHAPPIN  3 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.