This study evaluates the effectiveness of a voiding reeducation program as treatment for incontinence in children with a brain injury.
Children with cerebral palsy (CP) (Rosenbaum, 2007) gain bladder and bowel control at older age compared to typical developing children (Ozturk, 2006). The incidence of urinary incontinence during day and night, fecal incontinence and constipation is higher in this population. Incontinence in children is often treated with urotherapy. This is a nonsurgical, nonpharmacological treatment for lower urinary tract dysfunctions. Standard urotherapy is noninterventional and it includes giving information, instructions, advice regarding life-style, fluid intake and bladder diaries. Additionally specific interventions can be used, such as: various forms of pelvic floor training, behavioral modification, biofeedback, electrical stimulation and catheterization (Neveus, 2006). Recent research has proven urotherapy to be successful for the treatment of children with daytime incontinence (Mulders, 2010). Despite the high prevalence of incontinence in children with CP the possible treatment strategies in this population are poorly investigated. Far too often, urinary incontinence in children with CP is considered a normal, unavoidable and even a minor problem. Aim: Investigate the influence of individualized urotherapy on the (in)continence of children with CP. The included children with CP will be randomized and stratified for type of CP and mental abilities into 2 groups: the intervention group and the control group. The intervention group will receive immediate therapy. After one year of therapy, a follow- up of 6 months will be applied. The control group will start 6 months later and information will be used as control group. Incontinent children without CP will receive therapy and will also act as control group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
Individualized
University Hospital, Ghent
Ghent, Belgium
Subjective report of change in urinary incontinence measured by questionnaire
Time frame: Baseline and 3-6-12 months + follow-up
Lower urinary tract symptoms (LUTS) measured by questionnaire
Time frame: baseline and 6-12 months
Drinking behaviour measured by drinking and voiding charts
Time frame: Baseline and 6-12 months
Constipation/fecal incontinence measured by ROME III criteria
Time frame: Baseline and 6-12 months
voiding variables and pelvic floor activity during micturition measured by uroflow/EMG
Uroflow and pelvic floor EMG + postmictional residue
Time frame: Baseline and 3-6-12 months
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