Premium
Impact of bowel management in alleviating symptoms of urinary incontinence in patients with spina bifida associated with overactive bladder and detrusor sphincter dyssynergia
Author(s) -
Radojicic Zoran,
Milivojevic Sasa,
Milic Natasa,
Lazovic Jelena Milin,
Lukac Marija,
Sretenovic Aleksandar
Publication year - 2019
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14414
Subject(s) - medicine , dyssynergia , anticholinergic , constipation , spina bifida , urinary incontinence , urology , overactive bladder , urinary bladder , urinary system , anticholinergic agents , surgery , alternative medicine , pathology
Objective To examine the effects of bowel management on urinary incontinence in patients with spina bifida associated with overactive bladder ( OAB ) and detrusor sphincter dyssynergia ( DSD ). Materials and Methods The research was carried out during the period 2014–2017. A total of 35 patients (group 1) were administered bowel management combined with anticholinergic medication therapy and clean intermittent catheterization ( CIC ) and 35 patients (group 2) were treated only with anticholinergic medication therapy and CIC . Bowel management included daily enema, laxative application and a special diet, with the aim of treating constipation, evaluated according to the Roma III criteria and echosonographically determined transversal rectal diameter. The effects of the administered bowel management on urinary incontinence were assessed according to the mean dry interval between two CIC s for all patients. All patients were followed up for 1 year, during which data were prospectively collected. Results There was no statistically significant difference with regard to age, gender and baseline clinical features between the two groups. In group 1, the mean ± sd dry interval between two CIC s was 150.0 ± 36.4 min, and group 2 it was 101.3 ± 51.6 min. There was a significant difference in urinary incontinence, i.e. in the mean dry interval, between the two groups ( P < 0.001). Conclusion Administering bowel management considerably increased the mean dry interval, thus greatly alleviating the symptoms of urinary incontinence. For this reason, bowel management should form an integral part of the treatment of patients with spina bifida and OAB and DSD .