Effectiveness of standard urotherapy (basic bladder advice) and combination therapies in managing bladder dysfunction in children with treated behavioral disorders: Results of a prospective cohort (DABBED) study.

Autor: Eliezer DD; John Hunter Children's Hospital, New Lambton Heights, New South Wales, Australia.; University of Newcastle, Callaghan, New South Wales, Australia., Samnakay N; Department of Surgery, Perth Children's Hospital, Perth, Western Australia, Australia.; Division of Surgery, Medical School, University of Western Australia, Perth, Western Australia, Australia., Starkey MR; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.; Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, Victoria, Australia., Deshpande AV; John Hunter Children's Hospital, New Lambton Heights, New South Wales, Australia.; University of Newcastle, Callaghan, New South Wales, Australia.; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.; Urology Unit, Department of Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Jazyk: angličtina
Zdroj: Lower urinary tract symptoms [Low Urin Tract Symptoms] 2021 Oct; Vol. 13 (4), pp. 490-497. Date of Electronic Publication: 2021 Jul 27.
DOI: 10.1111/luts.12400
Abstrakt: Aims: We evaluated the efficacy of standard urotherapy and combination therapies in treatment of bladder dysfunction in children with treated behavioral disorders.
Methods: Prospective study of children (6-16 years) with bladder dysfunction and behavioral disorders was conducted between March 2018-2020. Eligible children were initially offered standard urotherapy and those with no response at 3 months were offered combination therapies. Symptomatic response, changes in Akbal score and PinQ score were reported at 6 months and outcomes were correlated to behavioral diagnoses and medications.
Results: Thirty-nine consecutive children (male = 27, mean age [SD] 10.3 [±2.0] years) were recruited, of whom 29 completed the study (five lost to follow-up, three non-compliant to treatment, two excluded). Thirty-four (87%) children had attention deficit/hyperactivity disorder. Monosymptomatic nocturnal enuresis (n = 11) and non-monosymptomatic enuresis (n = 17) were the commonest diagnoses. Following 3-month review, 14 (38%) children continued to receive standard urotherapy, while 15 (41%) children were transitioned to combination therapy. At 6-month review, complete/partial response was seen in 62% (23/37) and no response in 16% (6/37); with 32% (12/37) responding to standard urotherapy alone. Akbal symptom scores (15.9-11.5; P < 0.01) and PinQ scores (26.0-19.5; P = 0.008) improved significantly at 6-month follow-up. Type of underlying behavioral disorder(s) or medications for behavioral disorder did not influence the outcomes.
Conclusion: This study confirms that children with underlying behavioral disorders are able to have a good response to the appropriate therapy for their bladder dysfunction with a third of children responding to standard urotherapy alone.
(© 2021 John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje