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15:42 - 15:48
ICCS S6-3
(LO)
BLADDER AND BOWEL TRAINING - A PROSPECTIVE EVALUATION OF AN
UROTHERAPEUTIC TRAINING PROGRAM
Alexander VON GONTARD, Justine NIEMCZYK, Silke WACHS, Catharina WAGNER and Monika EQUIT
Saarland University Hospital, Department of Child and Adolescent Psychiatry, Homburg, GERMANY
PURPOSE
A manualized bladder and bowel training program was developed for children with therapy-resistant incontinence. The
effectiveness was evaluated in a prospective design, including a follow-up assessment. The program comprises
information about anatomy, pathophysiology, nutrition, drinking, stress and emotion regulation and was performed in
groups (2-6 children in 7-9 weekly sessions) or individually (3 sessions).
MATERIAL AND METHODS
Preliminary data of 33 children with therapy-resistance (mean age 8.8 years; 23 boys) are presented. 14 children
received group and 19 individual therapy. Incontinence frequency, treatment success (complete response: 100%
reduction of symptoms; partial response: 50-99% reduction), as well as psychological symptoms (Child Behavior
Checklist (CBCL)) were assessed before and after the treatment, as well as 6 months later.
RESULTS
Frequencies of daytime urinary incontinence (DUI) were significantly reduced from 4.4 wetting episodes/week (before
training) to 3.7 (after training) to 1.8 (6 months after training). Frequencies of fecal incontinence (FI) did not decrease
significantly (2.3 soiling episodes/week to 2.1 to 2.4). 50% of children with DUI and 23.1% of children with FI had a
complete response at follow-up. Reduction of soiling and complete response in FI were higher in the group than in the
individual training. Total, internalizing and externalizing psychological symptoms also decreased significantly.
CONCLUSIONS
This training program is an effective treatment for children with therapy-resistant incontinence, especially DUI.
Symptoms still improved 6 months after training. Additionally, the training program is helpful to reduce psychological
symptoms.