Characteristics of Children Successfully Treated for Daytime Urinary Incontinence.

Abstract

Objective: A stepwise approach is recommended for the treatment of daytime urinary incontinence, with standard urotherapy as the first-line treatment, followed by pharmacological treatment when standard urotherapy is unsuccessful. This study was aimed at characterizing and comparing children with an overactive bladder and daytime urinary incontinence who became continent solely on standard urotherapy and those who achieved continence on a combination of standard urotherapy and pharmacological treatment.

Methods: This retrospective study included 221 patients with complete continence during the day.

Results: Of these patients, 104 (47%) were successfully treated with standard urotherapy, and 117 (53%) required pharmacological treatment. Children who achieved continence on a combination of standard urotherapy and pharmacological treatment had significantly more baseline incontinence episodes during the daytime (p = 0.001) and lower voided volumes (voided volume/estimated bladder capacity: 37 and 42 mL respectively, p = 0.0085) compared with children who were treated with standard urotherapy only. Half the patients underwent an initial screening, including the use of a bladder diary, without the need for time-consuming and complex urotherapy.

Conclusions: Most children achieved daytime continence solely through standard urotherapy. Additionally, half of the patients achieved continence at the initial screening, including the use of the bladder diary. Children requiring additional pharmacological treatment to achieve continence have more severely overactive bladders.