AN EMPIRICAL TREATMENT ALGORITHM FOR INCONTINENT CHILDREN
| Autor: | Klaus-Peter Jünemann, Arne-Daniela Marschall-Kehrel, Helmut Madersbacher, G. Kramer, Gerd Mürtz |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Adolescent Urology media_common.quotation_subject medicine.medical_treatment Urinary incontinence Benzilates Biofeedback Urination Cholinergic Antagonists Internal medicine medicine Humans Child Desmopressin Retrospective Studies media_common Pelvic floor business.industry Urinary Incontinence medicine.anatomical_structure El Niño Child Preschool Female Propiverine medicine.symptom business Algorithms medicine.drug |
| Zdroj: | Journal of Urology. 171:2667-2671 |
| ISSN: | 1527-3792 0022-5347 |
| Popis: | Successful response rates of monotherapeutic strategies in urge incontinent children are limited. We evaluate whether adjuvant treatment improves outcomes.Incontinent children were evaluated according to International Consultation on Incontinence standards. Propiverine (0.4 mg/kg) was applied 2 times daily for 4 weeks (treatment period 1) before reevaluation. Primary outcome was achievement of continence and secondary outcome was improvement of functional bladder capacity. In partial responders an alternative adjuvant treatment was initiated for another 12 weeks (treatment period 2).Of 70 enrolled patients 29 achieved continence (responders) and 35 responded partially and were assigned to adjuvant treatment, which consisted of selective alpha-blocker for functional bladder outflow obstruction (6), desmopressin for excessive nocturnal urine production (19) and biofeedback for increased pelvic floor activity during micturition (10). Only 6 nonresponders (9%) were assigned to specialized management. After treatment 2, 20 of the 35 partial responders achieved continence, thus avoiding specialized management.Propiverine monotherapy for incontinent children is effective. However, applying adjuvant treatment modalities to partial responders increases overall efficacy rates. |
| Databáze: | OpenAIRE |
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