Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

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S21-9 (P)
IMPACT OF INITIATING A PRACTICE WIDE LOWER URINARY TRACT
DYSFUNCTION PROGRAM
Patrick MCKENNA1, Thomas W BENTLEY2, Glen E LEVERSON3 and Christina J SAUDER4
1) University of Wisconsin School of Medicine and Public Health, Department of Urology, Division of Pediatric Urology,
Madison, USA - 2) University of Wisconsin School of Medicine and Public Health, Deptartment of Urology, Madison, USA -
3) University of Wisconsin School of Medicine and Public Health, Department of Surgery, Madison, USA - 4) UW School
of Medicine and Public Health, Department of Urology, Division of Pediatric Urology, Madison, USA
INTRODUCTION
In 2012 our group initiated a protocol based, practice-wide incontinence program. Referring primary care providers were
educated on the protocol. It consisted of initial extensive patient education focused on elimination education. If no
improvement occurred, then non-invasive screening was initiated. There was delayed use of medications and treatment
was based on the non-invasive screening. We assessed our practice before and after initiating the program in regards to
urinary tract infections (UTIs), surgical treatment of vesicoureteral reflux (VUR), and prescribing of medication.
METHODS
A retrospective chart review was performed on 4-18 y.o. patients with LUTD who were treated in the protocol driven
program (N=341) and who were treated previously (N=415). Rates of UTIs, VUR surgery, and prescribing of
medications were assessed in each program using the methods of Kaplan & Meier and compared between programs with
a logrank test. P-values < 0.05 were considered significant.
RESULTS
By 3 months post 1st clinic visit, UTI rates were significantly less in the protocol program (p<.01). By 12 months post 1st
clinic visit, VUR surgery rates were significantly less in the protocol program (p<.01). By 12 months post 1st clinic visit,
prescribing of medication rates were significantly less in the protocol program (p<.001).
CONCLUSIONS
The data suggest that the protocol driven program successfully decreased rates of UTIs, surgical treatment of VUR and
prescribing of medication in children with LUTD since its initiation in 2012. This non-invasive and less pharmaceutically
inclined program could be a useful model for other continence programs.
FUNDING SOURCE: None