Abstract General Information

Title

EFFECTIVENESS OF GROUP-BASED STANDARD UROTHERAPY

Introduction and objective

First-line treatment for lower urinary tract symptoms in functional disorders is standard urotherapy. The study investigates effectiveness of group therapy or voiding class on symptom reduction and quality of life in children with lower urinary tract symptoms.

Method

A prospective cohort study was conducted between April 2021 and June 2023 including children, aged five to twelve, with lower urinary tract symptoms. Children attend the voiding class in groups of four and receive standard urotherapy following ICCS guidelines. Initial results are evaluated eight weeks after the voiding class as part of a follow-up consultation with the physician. Data is collected through bladder diaries including three days and fourteen nights and the validated Dutch Vancouver Symptom Score for Dysfunctional Elimination Syndrome (VSSDES) and Pediatric urinary incontinence Quality of life (PIN-Q) questionnaires. Adherence was evaluated by means of the amount of documents filled in before and after voiding class.

Results

Sixty children were included in the study of which data from 43 children is currently available. Children had a mean age of 7,3 years old, ranging between five and ten years old and 70 % of them were male. 43 % of the children had combined daytime incontinence and enuresis, 52 % had isolated enuresis and 5% had isolated daytime incontinence. Eight weeks after voiding class a transition was seen with less children experiencing combined daytime incontinence and enuresis (37%) and two children becoming completely dry (5%). A statistically significant decrease in the VSSDES (p = 0.006) and adherence (p < 0.001) was found. No statistically significant changes were seen in PINQ score, however, a PINQ score indicating severe impact on quality of life was only seen before voiding class. In nineteen children (44%) an initial bladder capacity lower or equal to 65 % of expected bladder capacity for age was present. A statistically significant increase in bladder capacity was seen in those children eight weeks after voiding class (51 % vs 66 %; p = 0.004). VSSDES and PINQ score exhibited higher scores before and after training in children with developmental disorders.

Conclusion

Standard urotherapy conducted as group therapy demonstrates effective symptom reduction after eight weeks of training. Possible influence of the presence of developmental disorders and low adherence generally seen in the study recommends shared decision making concerning individual and group therapy.