Adequate Fluid Intake, an Important Factor in the treatment of Urinary Incontinence in Children Suffering Mental and/or Motor Disability

Abstract

PURPOSE Urinary incontinence in mental and or motor disabled children is a common problem. Literature about therapy is scarce. In a prospective study the effect of urotherapy, particularly adequate fluid intake in these patients was evaluated. MATERIAL AND METHODS In a prospective study, 111 children, 66 boys and 45 girls, mean age 9.1 years, were included. Twenty-two were motor disabled, 16 were mental disabled and 73 suffered mental- and motor disability. All patients were put on a fluid intake schedule of 1500 ml/m 2 body surface. The mean follow-up was 22.9 months (12–30 months). Patients were evaluated with a diary, uroflow and bladderscan. RESULTS Forty-four children (39.6%) were dry at inclusion, 41 (36.9%) suffered urinary incontinence day and night, 11 (9.9%) were urinary incontinent during the day and 15 (13.5%) suffered nocturnal enuresis. In 18 children anticholinergics were started. Eleven of them became dry. The other children only got an adequate fluid intake schedule. Eight patients (7.2%) dropped out of the study. In the end 69 children (67%) were completely dry day and night, 14 (13.6%) remained urinary incontinent during day and night, 5 (4.9%) suffered urinary incontinence during the day and 15 (14.6%) suffered nocturnal enuresis. Seventy tree children (65.8%) drank at least 25% less than the physiologically necessary quantity. Initially 62 (55.9%) had a small bladdercapacity for age. This number decreased to 24 (21.6%) at the end of the study period. CONCLUSIONS Adequate fluid intake is an important part of urotherapy in the treatment of urinary incontinence in mental and / or motor disabled children.