Paediatric incontinence

AIMS: To compare the effects of functional electrical stimulation (FES) with conventional therapy and conventional therapy alone on improvement of faecal incontinence (FI) symptoms in a number of children with functional non-retentive FI. METHODS: Data of 28 children with FI were accepted for this retrospective study. The case group (n = 14) underwent FES + conventional therapy and the control group (n = 14) received conventional therapy only. Data of children with faecal retention, inflammatory, anatomic, metabolic and neurological disorders were excluded...

OBJECTIVE: To explore the therapeutic effects of biofeedback in the treatment of faecal incontinence (FI) after surgery for anorectal malformation (ARM). METHODS: Clinical data were collected from paediatric patients for postoperative biofeedback due to FI caused by ARM between May 2017 and November 2021. The data included the duration of symptoms, the integrity of the anal sphincter, anorectal manometry parameters, and FI scores. These patients were divided into the low ARM group (group A) and the high ARM group (group B)...

BACKGROUND: This prospective cohort study compared primary-school-aged outcomes between children with Hirschsprung disease (HD) following Soave, Duhamel or Swenson procedures. METHODS: Children with histologically proven HD were identified in British/Irish paediatric surgical centers (01/10/2010-30/09/2012). Parent/clinician outcomes were collected when children were 5-8 years old and combined with management/early outcomes data. Propensity score/covariate adjusted multiple-event-Cox and multivariable logistic regression analyses were used...

Purpose: The treatment and long term clinical outcomes of anorectal malformations (ARM) in children have always been the focus of pediatric surgeons. This study aimed at reporting our experience as far as long-term follow-up of ARM in children is concern. Methods: We enrolled patients treated between 1999 and 2019, and established selection criteria to choose appropriate subjects. A validated questionnaire was used to determine long-term quality of life outcomes...

AIM: Constipation is one of the most common complaints in childhood affecting the quality of life of both children and parents. This study intends to investigate rectal measurements on ultrasound and their relationship with bowel habits. METHODS: In this cross-sectional study, 100 children with functional constipation (FC) referred to a single hospital between 2018 and 2019 were enrolled. After obtaining informed consent, a questionnaire including demographic and constipation characteristics was completed, and a physical examination including digital rectal examination (DRE) was performed...

AIM: Many patients with anorectal malformations (ARM) experience a long-lasting problem with faecal incontinence (FI). We assessed the effectiveness of a pelvic floor rehabilitation program including transcutaneous functional electrical stimulation (TFES) in combination with pelvic floor muscle (PFM) exercises on post-surgical FI in children with ARM. METHODS: Data of 40 children at the age of 4 years or older who had undergone surgical correction for ARM and suffered from persistent FI referring for pelvic floor rehabilitation were analysed respectively...

BACKGROUND/OBJECTIVES: Rhabdomyosarcoma of the perianal/perineal region (PRMS) is rare, with poor survival and limited understanding of the functional consequences of treatment. DESIGN/METHODS: International Society of Pediatric Oncology (SIOP) malignant mesenchymal tumor (MMT) 95, Italian RMS 96, and European paediatric Soft tissue sarcoma Study Group (EpSSG) RMS 2005 studies were interrogated to identify factors that impact survival; in RMS 2005, functional outcomes were analyzed...

OBJECTIVE: The objective of the study was to compare the frequency of recurrence with 5% phenol in almond oil versus 15% hypertonic saline for pediatric idiopathic rectal prolapse. METHODOLOGY:  An open-label, randomized clinical trial was conducted at the Department of Paediatric Surgery, Services Hospital, Lahore, Pakistan, over a period of one year from May 1, 2018 to April 30, 2019. Altogether, 120 patients with idiopathic rectal prolapse were included in this study...

PURPOSE: Analysis of outcomes and follow-up of children who underwent the Malone antegrade continence enema (MACE) procedure in a UK tertiary paediatric surgery unit. METHODS: Children who underwent a MACE procedure from 1998 to 2020 were identified. Demographic and clinical data were obtained from contemporaneous records. Outcomes were categorised as full (success), partial or failure. RESULTS: Ninety-five children were identified for inclusion (chronic idiopathic constipation (CIC, 59), anorectal malformations (ARM, 23) and Hirschsprung's disease (HD, 13))...

OBJECTIVE: According to international guidelines, children with enuresis are recommended urotherapy, or basic bladder advice, before treatment with evidence-based alternatives such as the enuresis alarm is given. The efficacy of this strategy has, however, not been supported by controlled studies. We wanted to test if basic bladder advice is useful in enuresis. DESIGN: Randomised, controlled trial. SETTING: Paediatric outpatient ward, regional hospital...

As it is well known, in the 2000s the average lifespan reached unhoped-for values compared to those of the early 20th century. This incredible achievement was the combined result of improved living conditions and constant medical advancements, which together have contributed to a significant reduction in mortality. The sharp decline in infant mortality led to a general aging of the population and consequently to the great challenge of keeping the elderly healthy and self-sufficient for as long as possible. In Italy, 30% of the over-65s are not affected by any major condition and 20% have a chronic disease with no particular effects on their physical and cognitive functions, while 50% have multiple chronic morbidities that - in at least 40% of cases -result in consequent mobility problems or difficulties in performing everyday activities...

INTRODUCTION: The routine use of urodynamic studies (UDS) has been questioned. Additionally, the material and personnel costs are poorly remunerated. We aimed to analyse the UDS utilization in Germany. METHODS: We analysed UDS performed by hospitals based on quality reports from 2013 to 2019. A representative sample of 4 million insured persons was used to estimate outpatient UDS utilization from 2013 to 2018. RESULTS: There was an overall decrease of 14% in UDS in Germany from 2013 to 2018 (60,980 to 52,319; p = 0...

BACKGROUND: Nocturnal enuresis or 'bedwetting', is a form of night-time urinary incontinence occurring in younger children. A diagnosis can be socially disruptive and psychologically stressful for a child. The most common strategies used by parents are waking the child during the night to use the bathroom and limiting the child's water intake before going to bed. HYPOTHESIS/PURPOSE: To determine if a herbal capsule formulation taken once daily can reduce incidence and frequency of nocturnal enuresis in children...

INTRODUCTION: Girls with an anterior deflected urinary stream (ADUS) are known to wet the toilet rim and their buttocks while voiding. This deviation may prevent adopting an ideal toileting position and can thus develop into a functional voiding disorder. Although surgical correction of the urinary stream by a meatotomy is part of standard care in girls with ADUS and lower urinary tract symptoms (LUTS) at our center, little is known about the effect of this procedure on daytime urinary incontinence (DUI)...

CONTEXT: Long-term urinary and sexual outcomes after repair of anorectal malformations (ARMs) are currently affected by concomitant malformations of the urinary tract and genitalia, sacral anomalies, and the surgical approach. However, the overall prevalence of urinary and sexual dysfunction remains unclear. OBJECTIVE: To evaluate the prevalence of urinary and sexual dysfunction in patients aged >10 yr after repair of ARM in infancy. EVIDENCE ACQUISITION: A systematic literature review was performed using the Medline, Embase, and Cochrane databases...

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AIM: Giggle incontinence is a distinct entity of childhood daytime urinary incontinence (DUI), where children wet themselves only when they laugh. The prevalence of true giggle incontinence is unknown, with confusion about the diagnosis of urinary incontinence occurring during laughter and true giggle incontinence. The aim of the study is to improve our understanding of urinary incontinence during laughter by comparing those children with children who have DUI at other times, but not with laughter...

AIM: Information about healthy children's urinary tract symptoms is scarce but would be helpful in children with congenital urinary tract conditions. The aim of this study was to develop and evaluate a Lower Urinary Tract Dysfunction (LUTD) questionnaire. METHODS: A 15-item questionnaire based on definitions by the International Children's Continence Society (ICCS) about urinary tract function, was given to children 4-15 years old with no gastrointestinal or urinary tract conditions...

AIM: Enuresis, defined as intermittent incontinence occurring exclusively during sleep, affects 4-19% of children, but can be effectively treated using education and alarm-bell therapies. However, delays in treatment are likely to impact upon the quality of life of the child, parents and carers. Poor quality and incomplete referrals are thought to be a major driver of inefficiencies. The aim of this study was to explore characteristics of enuresis referrals on the waiting list for a general medicine clinic at a tertiary paediatric hospital...

An 8-month-old male child presented with the complaint of two separate urinary streams from the penis. The child had no complaints of incontinence or recurrent UTI (urinary tract infection). Initial diagnosis of urethrocutaneous fistula was made and proceeded to micturating cystourethrography (MCU) and found to be having a urethral duplication. The duplicated urethra was excised and accessory urethra closed. Postoperatively, the child was followed up for 1 year and had no complaints of recurrence or incontinence...