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Long‐term effect of conservative treatment versus low threshold endoscopic desobstruction on urine incontinence and urgency in boys with persistent overactive bladder symptoms: A cohort study
Author(s) -
Hennus Pauline M.L.,
van den Hoek Joop,
Hoes Arno W.,
Groenwold Rolf H.H.,
Bosch J.L. Ruud,
de Jong Tom P.V.M.,
de Kort Laetitia M.O.
Publication year - 2017
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.23214
Subject(s) - medicine , overactive bladder , lower urinary tract symptoms , urinary incontinence , single center , conservative treatment , cohort , urology , surgery , prostate , alternative medicine , pathology , cancer
Aims To assess the long‐term effects of two treatment strategies (low threshold endoscopic desobstruction vs. conservative treatment) on urinary incontinence (UI) and urgency‐frequency in boys. Methods Boys with persistent overactive bladder symptoms treated in two tertiary referral centers between 2006 and 2009 were included. Treatment strategy in center 1 was urethrocystoscopy (UCS) and in case of obstruction urethral desobstruction and in center 2 conservative. The primary outcome was time to being dry during daytime , secondary outcomes were being dry both day and night and presence of urgency‐frequency , using the “provisional” International Consultation on Incontinence Questionnaires Children's Lower Urinary Tract Symptoms (LUTS) questionnaire. Results Median age at start of treatment was 8.0 (IQR 6.4‐9.4) years in center 1 and 8.4 (IQR 6.0‐10.1) years in center 2. At baseline daytime incontinence was present in 100/104 children (96%, center 1) and 37/44 (84%, center 2). In center 1, UCS was performed in 98 (93%) boys, with desobstruction in 93 (88%), while in center 2 these numbers were 16 (36%), and 5 (11%). There were no differences between groups after a mean follow‐up of 5 years concerning dryness at daytime (HR 0.86, 0.56‐1.30), dryness day and night (HR 0.72, 0.51‐1.14), and presence of urgency‐frequency (HR 0.67, 0.38‐1.25). Conclusions The benefit of a strategy including low‐threshold UCS and endoscopic desobstruction in boys with urge incontinence and suspected infravesical obstruction to prevent LUTS and incontinence on the longer term could not be confirmed.