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Outcome of a standardized approach to childhood urinary symptoms—long‐term follow‐up of 720 patients
Author(s) -
Rittig Nikolaj,
Hagstroem Søren,
Mahler Birgitte,
Kamperis Konstantinos,
Siggaard Charlotte,
Mikkelsen Mette Marie,
Bower Wendy Fiona,
Djurhuus Jens C.,
Rittig Søren
Publication year - 2014
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22447
Subject(s) - medicine , enuresis , urinary incontinence , desmopressin , urinary system , cohort , regimen , pediatrics , surgery
Abstract Aims To investigate the relevance of enuresis subtyping for selection of treatment modality and for long‐term outcome in a large consecutive patient cohort. Materials and Methods We included all patients referred for urinary incontinence during a 5‐year period but excluding recurrent urinary tract infections (UTI). Type and severity of incontinence, prior history, results of examinations performed, number of visits, and effect of all treatments provided, were included in a clinical database. Results Seven hundred twenty children aged 4–16 years (mean 8.5 ± 2.2 years, 239 girls) were included in the analysis (42% with monosymptomatic (MNE), 55% with non‐MNE, and 3% with isolated daytime incontinence). Initial evaluation revealed only few underlying causes (one neurological and eight anatomical). Investigations showed significant differences between MNE and non‐MNE patients as both maximal voided volume and nocturnal urine volume was lower in non‐MNE patients ( P < 0.001). Follow‐up for average 1,587 days (3.4 years) was performed in 660 (92%) patients. A higher number of visits and a longer treatment period were needed for non‐MNE patients (on average 4.7 ± 2.8 visits) than MNE patients (3.1 ± 1.6 visits, P < 0.001). The most common treatment regimen that resulted in dryness in both MNE (40%) and non‐MNE (36%) was the alarm system. Interestingly, of the 539 patients who initially were referred due to desmopressin resistance 177 (33%) of these were dry on desmopressin monotherapy. Conclusions The study indicated that MNE and non‐MNE are two distinct disease entities with different optimal treatments and showed that the latter patients are more difficult and time‐consuming to manage. Neurourol. Urodynam. 33:475–481, 2014 . © 2013 Wiley Periodicals, Inc.