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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Children with CP - Therapy | Experimental | Children receive incontinence treatment during one year, after which a follow-up period of 6 months will be applied. Intervention includes standard urotherapy with or without pharmacotherapy/specific urotherapy |
|
| Children with CP - Control | No Intervention | Children are followed for 6 months, not receiving any treatment. After this follow-up period, children also receive incontinence treatment for 6 months. | |
| Children without CP | Active Comparator | Children receive incontinence treatment during 1 year. Intervention includes standard urotherapy with or without pharmacotherapy/specific urotherapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| urotherapy with or without pharmacotherapy | Other | Individualized |
|
| Measure | Description | Time Frame |
|---|---|---|
| Subjective report of change in urinary incontinence measured by questionnaire | Baseline and 3-6-12 months + follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Lower urinary tract symptoms (LUTS) measured by questionnaire | baseline and 6-12 months | |
| Drinking behaviour measured by drinking and voiding charts | Baseline and 6-12 months | |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Erik Van Laecke, PhD MD | University Hospital, Ghent | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital, Ghent | Ghent | 9000 | Belgium |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35732572 | Derived | Samijn B, Van den Broeck C, Plasschaert F, Pascal A, Deschepper E, Hoebeke P, Van Laecke E. Incontinence training in children with cerebral palsy: A prospective controlled trial. J Pediatr Urol. 2022 Aug;18(4):447.e1-447.e9. doi: 10.1016/j.jpurol.2022.05.014. Epub 2022 May 25. |
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| ID | Term |
|---|---|
| D053207 | Diurnal Enuresis |
| D014549 | Urinary Incontinence |
| D002547 | Cerebral Palsy |
| ID | Term |
|---|---|
| D004775 | Enuresis |
| D014555 | Urination Disorders |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
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| ID | Term |
|---|---|
| D004358 | Drug Therapy |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
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| Constipation/fecal incontinence measured by ROME III criteria |
| Baseline and 6-12 months |
| voiding variables and pelvic floor activity during micturition measured by uroflow/EMG | Uroflow and pelvic floor EMG + postmictional residue | Baseline and 3-6-12 months |
| D005261 |
| Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D019960 | Elimination Disorders |
| D001523 | Mental Disorders |
| D059411 | Lower Urinary Tract Symptoms |
| D020924 | Urological Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001925 | Brain Damage, Chronic |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |