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. Issue 4 (27th July 2021)

• Record Type: Journal Article
• Authors: Eliezer, Dilharan D.; Samnakay, Naeem; Starkey, Malcolm R.; Deshpande, Aniruddh V.
• Is Part Of: LUTS. Volume 13:Issue 4(2021)
• Page Start: 490
• Page End: 497
• Publication Date: 2021-07-27
• Subjects: ADHD -- autism -- behavioral disorder -- child -- urinary incontinence; Urology -- Periodicals; Urologic Diseases -- Periodicals; Urinary Tract Physiological Phenomena -- Periodicals; 616.62
• DOI: 10.1111/luts.12400
• Languages: English
• ISSNs: 1757-5664

Abstract

Abstract: 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.