Prospective Evaluation of Clinical Voiding Re-Education or Voiding School for Lower Urinary Tract Conditions in Children

Abstract

Purpose Prospective controlled study evaluating the results of a clinical voiding re-education programme or voiding school (VS) for treatment of lower urinary tract conditions (LUT) in children compared to no treatment. Material and Methods Thirty eight children with non neurogenic LUT conditions, resistant to out patient urotherapy, were included in a study protocol evaluating the effect of a clinical or in patient voiding re-education programme or urotherapy. Sixteen children on the waiting list for the same programme were included as control receiving no treatment while on the waiting list. The clinical voiding re-education programme consisted in instructions on voiding and drinking, individualised voiding diaries, pelvic floor biofeedback training, uroflowmetry, cognitive therapy and psychological support. Data on voiding, drinking, pelvic floor control, voided volume, uroflow, incontinence and stool habits were gathered before the programme, during the programme and 6 months after the programme. In the control group the same data were gathered when they were put on the waiting list and 6 months later. Results In the study group a positive effect of the VS was observed in 92% of children. Forty two% became completely dry, 24% changed from incontinence during day and night to incontinence day or night only while in 26% incontinence remained but in all patients the number of incontinence periods and the amount decreased. In the control group no differences were observed between intake and 6 months later. The study group did significantly better on voided volume and incontinence compared to the control group. Conclusions In this prospective controlled study a positive effect on voided volume and on incontinence with a clinical voiding re-education programme or voiding school is reported. This is the first prospective controlled study on the effects of urotherapy. Prospective controlled study evaluating the results of a clinical voiding re-education programme or voiding school (VS) for treatment of lower urinary tract conditions (LUT) in children compared to no treatment. Thirty eight children with non neurogenic LUT conditions, resistant to out patient urotherapy, were included in a study protocol evaluating the effect of a clinical or in patient voiding re-education programme or urotherapy. Sixteen children on the waiting list for the same programme were included as control receiving no treatment while on the waiting list. The clinical voiding re-education programme consisted in instructions on voiding and drinking, individualised voiding diaries, pelvic floor biofeedback training, uroflowmetry, cognitive therapy and psychological support. Data on voiding, drinking, pelvic floor control, voided volume, uroflow, incontinence and stool habits were gathered before the programme, during the programme and 6 months after the programme. In the control group the same data were gathered when they were put on the waiting list and 6 months later. In the study group a positive effect of the VS was observed in 92% of children. Forty two% became completely dry, 24% changed from incontinence during day and night to incontinence day or night only while in 26% incontinence remained but in all patients the number of incontinence periods and the amount decreased. In the control group no differences were observed between intake and 6 months later. The study group did significantly better on voided volume and incontinence compared to the control group. In this prospective controlled study a positive effect on voided volume and on incontinence with a clinical voiding re-education programme or voiding school is reported. This is the first prospective controlled study on the effects of urotherapy.