دورية أكاديمية
Bladder exstrophy-epispadias complex: The effect of urotherapy on incontinence.
| العنوان: | Bladder exstrophy-epispadias complex: The effect of urotherapy on incontinence. |
|---|---|
| المؤلفون: | van Geen FJ; Department of Urology, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: f.vangeen-2@umcutrecht.nl., Nieuwhof-Leppink AJ; Department of Medical Psychology and Urology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands., Wortel RC; Department of Pediatric Urology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands., de Kort LMO; Department of Urology, University Medical Center Utrecht, Utrecht, the Netherlands. |
| المصدر: | Journal of pediatric urology [J Pediatr Urol] 2024 Aug; Vol. 20 (4), pp. 645.e1-645.e5. Date of Electronic Publication: 2024 May 22. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: England NLM ID: 101233150 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4898 (Electronic) Linking ISSN: 14775131 NLM ISO Abbreviation: J Pediatr Urol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Kidlington, Oxford, UK : Elsevier, c2005- |
| مواضيع طبية MeSH: | Bladder Exstrophy*/surgery , Bladder Exstrophy*/therapy , Bladder Exstrophy*/complications , Epispadias*/complications , Epispadias*/therapy , Epispadias*/surgery , Urinary Incontinence*/therapy , Urinary Incontinence*/etiology, Humans ; Retrospective Studies ; Female ; Male ; Child ; Child, Preschool ; Plastic Surgery Procedures/methods ; Treatment Outcome ; Follow-Up Studies ; Quality of Life ; Urologic Surgical Procedures/methods ; Adolescent |
| مستخلص: | Introduction: Achieving urinary continence is a key goal in children born with the bladder exstrophy-epispadias complex (BEEC). Unfortunately, this goal is only moderately achieved despite sometimes extensive surgical treatment. Undergoing repeated hospitalization and operations may consequently have a negative impact on quality of life. We therefore believe that other, conservative treatment options should be explored in an earlier stage of incontinence treatment in BEEC patients. As part of this, an intensive urotherapy program based on was offered to patients with persistent incontinence after reconstructive surgery for BEEC. Objective: The aim of this study is to evaluate the benefits of intensive urotherapy on incontinence after reconstructive surgery in children with BEEC. Study Design: A retrospective chart study was performed including all children who were enrolled in an intensive urotherapy program because of persistent incontinence after reconstructive surgery for BEEC. Urotherapy consisted of a ten-day inpatient training program based on cognitive behavioral therapy, with intensive follow-up by experienced urotherapists. Main outcome measurement was continence, expressed as the percentage of children that achieved complete continence (good result; 100% dry) or 50-99% decrease of wet days a week (improved result) after treatment. Results: Data of 33 patients with a mean age of 10.6 years were analyzed. In 61% of cases (20/33) an improved or good result was reported on incontinence after urotherapy. Children with classic bladder exstrophy more often achieved a good or improved result (13/16; 81%), compared to children with epispadias (6/16; 38%). The only patient with a cloacal exstrophy completed treatment with an improved result. From the group of patients with persistent incontinence, 75% (12/16) reported that the complaints were socially acceptable at the end of follow-up. Discussion: By following our intensive urotherapy program the majority of patients achieved complete continence or improved incontinence. In addition, our results show that the inpatient training program has a positive impact on acceptance in cases of persistent incontinence. The urotherapists offer individualized care and clear guidance, which we deem essential elements of successful treatment. Considering that repeated surgery may impede progress and offers no guarantee of continence, we recommend giving preference to conservative treatment options. Conclusion: Our results show that 37% (12/33) of patients with BEEC who were enrolled in our intensive urotherapy program because of persistent incontinence after reconstructive surgery, achieved complete continence after urotherapy and 63% (21/33) still experienced some degree of incontinence. 75% of patients who did not achieve complete continence, described the remaining incontinence as socially acceptable. These findings strongly support counselling patients with BEEC to consider conservative treatment before opting for further surgery. Competing Interests: Declaration of competing interest None declared. (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Bladder exstrophy-epispadias complex; Incontinence; Urotherapy |
| SCR Disease Name: | Bladder Exstrophy and Epispadias Complex |
| تواريخ الأحداث: | Date Created: 20240531 Date Completed: 20240816 Latest Revision: 20240816 |
| رمز التحديث: | 20240818 |
| DOI: | 10.1016/j.jpurol.2024.05.013 |
| PMID: | 38821732 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1873-4898 |
|---|---|
| DOI: | 10.1016/j.jpurol.2024.05.013 |