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The goal of this study was to determine the Minimal Clinically Important Difference (MCID) for the Dysfunctional Voiding and Incontinence Symptom Score (DVISS) and the Pediatric Incontinence Questionnaire (PIN-Q) in children with urinary incontinence (UI).
100 children with UI will receive standard urotherapy (SU) for 8 weeks. UI-related symptoms and quality of life (QoL) will be assessed with the DVISS and PIN-Q baseline and after treatment. The receiver operating characteristic (ROC) analysis and the Gamma coefficient will be employed to assess responsiveness.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard urotherapy (SU) | Experimental | Children with UI will receive SU as previously recommended. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Standard Urotherapy (SU) | Other | SU will be included appropriate provision of information and demystification, lifestyle advice, instructions, behavioral modifications to achieve optimal bladder and bowel habits, registration of symptoms and voiding habits, support, and encouragement |
| Measure | Description | Time Frame |
|---|---|---|
| Dysfunctional Voiding and Incontinence Symptom Score (DVISS) | DVISS includes 14 items: 13 assess lower urinary tract symptoms (LUTS), voiding and defecation habits day and night, and one evaluates impact on severity and daily life activities (DLA). A score of 8.5+ indicates abnormal voiding; higher scores mean more severe disease. | Baseline |
| Dysfunctional Voiding and Incontinence Symptom Score (DVISS) | DVISS includes 14 items: 13 assess lower urinary tract symptoms (LUTS), voiding and defecation habits day and night, and one evaluates impact on severity and daily life activities (DLA). A score of 8.5+ indicates abnormal voiding; higher scores mean more severe disease. | At Week 8, immediately after completion of the 8-week intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Pediatric Urinary Incontinence Quality of Life Questionnaire (PIN-Q) | This 4-point Likert scale assesses the emotional impact of UI on a child, with 20 questions and a maximum score of 80. Higher scores mean a greater impact on QoL: 0-20 is mild, 21-50 moderate, and 51+ severe. | Baseline |
| Pediatric Urinary Incontinence Quality of Life Questionnaire (PIN-Q) |
| Measure | Description | Time Frame |
|---|---|---|
| Global Rating Change (GRC) | The GRC comprised seven responses, ranging from 1 to 5, indicating "very much better," "slightly better," "no change," "slightly worse," and "very much worse," respectively. | At Week 8, immediately after completion of the 8-week intervention |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zeynep Yıldız Kızkın | Contact | +905346945085 | pt.zeynepyildiz@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Zeynep Yıldız Kızkın | Artvin Coruh University | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39648965 | Background | Watanabe Y, Ikeda H, Ono T, Oyake C, Endo S, Onuki Y, Fuyama M, Watanabe T. Prevalence of Urinary Incontinence and Its Association With Neurodevelopmental Disorders Among Children in Japan. Neurourol Urodyn. 2025 Feb;44(2):458-463. doi: 10.1002/nau.25637. Epub 2024 Dec 9. | |
| 33510509 | Background | Shrestha N, Sahukhala S, K C D, Sandalcidi D, Adhikari SP. Prevalence of Urinary Incontinence in School Going Children: A Cross-sectional Study. J Nepal Health Res Counc. 2021 Jan 21;18(4):676-680. doi: 10.33314/jnhrc.v18i4.2506. |
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| ID | Term |
|---|---|
| D014549 | Urinary Incontinence |
| ID | Term |
|---|---|
| D014555 | Urination Disorders |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
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In this prospective study, one treatment group was formed to receive SU.
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|
This 4-point Likert scale assesses the emotional impact of UI on a child, with 20 questions and a maximum score of 80. Higher scores mean a greater impact on QoL: 0-20 is mild, 21-50 moderate, and 51+ severe. |
| At Week 8, immediately after completion of the 8-week intervention |
| 30583907 | Background | Linde JM, Nijman RJM, Trzpis M, Broens PMA. Prevalence of urinary incontinence and other lower urinary tract symptoms in children in the Netherlands. J Pediatr Urol. 2019 Apr;15(2):164.e1-164.e7. doi: 10.1016/j.jpurol.2018.10.027. Epub 2018 Nov 8. |
| 33478902 | Background | Nieuwhof-Leppink AJ, Hussong J, Chase J, Larsson J, Renson C, Hoebeke P, Yang S, von Gontard A. Definitions, indications and practice of urotherapy in children and adolescents: - A standardization document of the International Children's Continence Society (ICCS). J Pediatr Urol. 2021 Apr;17(2):172-181. doi: 10.1016/j.jpurol.2020.11.006. Epub 2020 Nov 5. |
| 32472266 | Background | Tekgul S, Stein R, Bogaert G, Undre S, Nijman RJM, Quaedackers J, 't Hoen L, Kocvara R, Silay MS, Radmayr C, Dogan HS. EAU-ESPU guidelines recommendations for daytime lower urinary tract conditions in children. Eur J Pediatr. 2020 Jul;179(7):1069-1077. doi: 10.1007/s00431-020-03681-w. |
| 33148456 | Background | Malhotra NR, Kuhlthau KA, Rosoklija I, Migliozzi M, Nelson CP, Schaeffer AJ. Children's experience with daytime and nighttime urinary incontinence - A qualitative exploration. J Pediatr Urol. 2020 Oct;16(5):535.e1-535.e8. doi: 10.1016/j.jpurol.2020.10.002. Epub 2020 Oct 18. |
| 36123285 | Background | Nacif A, de Abreu GE, Bessa Junior J, Veiga ML, Barroso U. Agreement between the visual analogue scale (VAS) and the dysfunctional voiding scoring system (DVSS) in the post-treatment evaluation of electrical nerve stimulation in children and adolescents with overactive bladder. J Pediatr Urol. 2022 Dec;18(6):740.e1-740.e8. doi: 10.1016/j.jpurol.2022.07.032. Epub 2022 Aug 3. |
| 22236468 | Background | Thibodeau BA, Metcalfe P, Koop P, Moore K. Urinary incontinence and quality of life in children. J Pediatr Urol. 2013 Feb;9(1):78-83. doi: 10.1016/j.jpurol.2011.12.005. Epub 2012 Jan 10. |
| 10812317 | Background | Husted JA, Cook RJ, Farewell VT, Gladman DD. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol. 2000 May;53(5):459-68. doi: 10.1016/s0895-4356(99)00206-1. |
| 31060913 | Background | Nieuwhof-Leppink AJ, Schroeder RPJ, van de Putte EM, de Jong TPVM, Schappin R. Daytime urinary incontinence in children and adolescents. Lancet Child Adolesc Health. 2019 Jul;3(7):492-501. doi: 10.1016/S2352-4642(19)30113-0. Epub 2019 May 4. |
| 15711352 | Background | Akbal C, Genc Y, Burgu B, Ozden E, Tekgul S. Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. J Urol. 2005 Mar;173(3):969-73. doi: 10.1097/01.ju.0000152183.91888.f6. |
| 33844342 | Background | Frawley H, Shelly B, Morin M, Bernard S, Bo K, Digesu GA, Dickinson T, Goonewardene S, McClurg D, Rahnama'i MS, Schizas A, Slieker-Ten Hove M, Takahashi S, Voelkl Guevara J. An International Continence Society (ICS) report on the terminology for pelvic floor muscle assessment. Neurourol Urodyn. 2021 Jun;40(5):1217-1260. doi: 10.1002/nau.24658. Epub 2021 Apr 12. |
| 20044494 | Background | Greco NJ, Anderson AF, Mann BJ, Cole BJ, Farr J, Nissen CW, Irrgang JJ. Responsiveness of the International Knee Documentation Committee Subjective Knee Form in comparison to the Western Ontario and McMaster Universities Osteoarthritis Index, modified Cincinnati Knee Rating System, and Short Form 36 in patients with focal articular cartilage defects. Am J Sports Med. 2010 May;38(5):891-902. doi: 10.1177/0363546509354163. Epub 2009 Dec 31. |
| 20638823 | Background | Lehman LA, Velozo CA. Ability to detect change in patient function: responsiveness designs and methods of calculation. J Hand Ther. 2010 Oct-Dec;23(4):361-70; quiz 371. doi: 10.1016/j.jht.2010.05.003. Epub 2010 Jul 17. |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D059411 | Lower Urinary Tract Symptoms |
| D020924 | Urological Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |