Multi-center randomized controlled trial of cognitive treatment, placebo, oxybutynin, bladder training, and pelvic floor training in children with functional urinary incontinence.

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van Gool, Jan D (author)

Multi-center randomized controlled trial of cognitive treatment, placebo, oxybutynin, bladder training, and pelvic floor training in children with functional urinary incontinence.

Article/chapterEnglish2014

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2013-06-15
Wiley,2014

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LIBRIS-ID:oai:gup.ub.gu.se/183848
https://gup.ub.gu.se/publication/183848URI
https://doi.org/10.1002/nau.22446DOI

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Language:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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OBJECTIVE: Functional urinary incontinence causes considerable morbidity in 8.4% of school-age children, mainly girls. To compare oxybutynin, placebo, and bladder training in overactive bladder (OAB), and cognitive treatment and pelvic floor training in dysfunctional voiding (DV), a multi-center controlled trial was designed, the European Bladder Dysfunction Study. METHODS: Seventy girls and 27 boys with clinically diagnosed OAB and urge incontinence were randomly allocated to placebo, oxybutynin, or bladder training (branch I), and 89 girls and 16 boys with clinically diagnosed DV to either cognitive treatment or pelvic floor training (branch II). All children received standardized cognitive treatment, to which these interventions were added. The main outcome variable was daytime incontinence with/without urinary tract infections. Urodynamic studies were performed before and after treatment. RESULTS: In branch I, the 15% full response evolved to cure rates of 39% for placebo, 43% for oxybutynin, and 44% for bladder training. In branch II, the 25% full response evolved to cure rates of 52% for controls and 49% for pelvic floor training. Before treatment, detrusor overactivity (OAB) or pelvic floor overactivity (DV) did not correlate with the clinical diagnosis. After treatment these urodynamic patterns occurred de novo in at least 20%. CONCLUSION: The mismatch between urodynamic patterns and clinical symptoms explains why cognitive treatment was the key to success, not the added interventions. Unpredictable changes in urodynamic patterns over time, the response to cognitive treatment, and the gender-specific prevalence suggest social stress might be a cause for the symptoms, mediated by corticotropin-releasing factor signaling pathways. Neurourol. Urodynam. © 2013 Wiley Periodicals, Inc.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Pediatrik hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Pediatrics hsv//eng
anticholinergics; bladder training; corticotropin-releasing factor; cognitive treatment; dysfunctional voiding; incontinence; urinary tract infection; urge syndrome; urodynamics; pelvic floor training

Added entries (persons, corporate bodies, meetings, titles ...)

de Jong, Tom P V M (author)
Winkler-Seinstra, Pauline (author)
Tamminen-Möbius, Tytti (author)
Lax, Hildegard (author)
Hirche, Herbert (author)
Nijman, Rien J M (author)
Hjälmås, Kelm,1933Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics (author)
Jodal, Ulf,1938Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics(Swepub:gu)xjodul (author)
Bachmann, Hannsjörg (author)
Hoebeke, Piet (author)
Walle, Johan Vande (author)
Misselwitz, Joachim (author)
John, Ulrike (author)
Bael, An (author)
Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för pediatrik (creator_code:org_t)

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In:Neurourology and Urodynamics: Wiley33:5, s. 482-4870733-2467

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By the author/editor: van Gool, Jan D; de Jong, Tom P V ...; Winkler-Seinstra ...; Tamminen-Möbius, ...; Lax, Hildegard; Hirche, Herbert; show more...; Nijman, Rien J M; Hjälmås, Kelm, 1 ...; Jodal, Ulf, 1938; Bachmann, Hannsj ...; Hoebeke, Piet; Walle, Johan Van ...; Misselwitz, Joac ...; John, Ulrike; Bael, An; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Pediatrics

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By the university: University of Gothenburg

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