Urotherapy Book

9 and movement analysis. Physiotherapists may use abdominal and perineal ultrasound for the assessment of pelvic floor and abdominal muscle function and provide biofeedback. The role of Clinicians Clinician (urologist/pediatrician) will assess the child's symptoms, medical history and do a physical examination and rule out neurogenic and anatomical problems. In case urotherapy fails, the medical team may decide to prescribe medication and/or perform further investigations, such as invasive urodynamic investigation or cystoscopy. The role of Psychologists Incontinence can be associated with a wide variety of psychological symptoms and disturbances. If behavioural questionnaires, like the CBCL or SDQ suggest emotional and behavioural problems, a full psychiatric/psychological assessment and treatment are necessary. Also, when treatment fails due to behavioural problems, anxiety, or depression, it is good to seek the advice of a psychologist.20 4. Assessment and Diagnosis The diagnosis can be made based on history, physical examination, uroflowmetry, noninvasive ultrasound, and voiding /bowel diaries. The dysfunctional voiding symptom score (DVSS) is the most commonly used tool to evaluate and monitor treatment progress. Behavioural questionnaires and quality of life (QoL) questionnaires are important tools to evaluate children’s functioning. 1,-8, It is the task of a urotherapist to assess a child’s problem, its severity, the impact on quality of life, and motivation for treatment and to decide which steps (treatment sequence) or elements of urotherapy are needed. Critical thinking is crucial, and the following three questions should be asked in the beginning and re-evaluated during treatment: