30th ESPU Congress - Lyon, France - 2019

S1: FUNCTIONAL VOIDING DISORDERS 2

Moderators: Alexandra Vermandel (Belgium), Angela Downer (UK)

ESPU-Nurses Meeting on Thursday 25, April 2019, 10:20 - 11:00


10:20 - 10:30
S1-1 (LO)

IMPACT OF HYPNOSIS ON INTERMITTENT CATHETERIZATION AND URODYNAMIC STUDIES IN CHILDREN: A PRELIMINARY STUDY

Eliane JOSSET RAFFET, Lise NATIO, Marie Elise JEREMIE, Alaa ELGHONEIMI and Annabel PAYE JAOUEN
Robert Debré University Hospital, AP-HP, University Paris Diderot. Centre de référence de Malformations Rares des voies Urinaires (MARVU), Paediatric Urology, Paris, FRANCE

PURPOSE

Clean Intermittent catheterization (CIC) and urodynamic studies (UDS) in children could be painful and stressful. Our objective was to assess the impact of hypnosis on acceptance and the realisation of the studies or the CIC.

MATERIAL AND METHODS

The study was conducted prospectively in our centre between June 2016 and June 2018. Children needing CIC were included. Hypnosis sessions were coordinated by therapeutic education (TPE) team at the outpatient clinic. Children with Mitrofanoff, psychiatric trouble, not speaking English or French were excluded. For CIC: feasibility of the catheterization, number of hypnosis and TPE sessions, anxiety and pain (self or hetero assessment by digital scale) were collected at the first day, one week, one month and six months. For UDS, we assessed feasibility of the study, anxiety and pain, children had only one hypnosis session.

RESULTS

31 children (9 girls, 22 boys) mean age 9 years (1-17) were included. 14 children had CIC, 57% were anxious or painful on first session. At one month, CIC was done daily by 100% of parents or children. Anxiety and pain disappeared in 92% of patients. Six months later, no patient had pain. 17 patients had hypnosis session during UDS. The study was feasible for all. 35% were anxious and 41% had pain.

CONCLUSIONS

Our preliminary study showed the feasibility of hypnosis in the daily practice of the outpatient clinic of pediatric urology. Hypnosis seems to improve the acceptance rate for CIC. UDS under hypnosis was also feasible. These results need to be validated compared to control groups. In our daily practice, its use is also extended to another indications.


10:30 - 10:40
S1-2 (LO)

SELF-PERFORMANCE AND PERCEPTION IN CHILDREN WITH NOCTURNAL ENURESIS

Neeraj DIXIT 1, Shridhar GHAGANE 2, Namrata MISALE 3, Mubashir ANAGOLKAR 3 and Rajendra NERLI 1
1) KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Urology, Belagavi, INDIA - 2) KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical, Urology, Belagavi, INDIA - 3) JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Public Health, Belagavi, INDIA

PURPOSE

To study the self-performance and perception in children with Nocturnal Enuresis (NE) in the age group between (6 to 9 years). 

MATERIAL AND METHODS

School going children with (NE) between the age of 6 & 9 years were prospectively assessed for self-performance and perception. A detailed history was noted and all children were physically assessed. ESPQ (Early School Personality Questionnaire) test profile was performed in all the children. 

RESULTS

During the period Jan 2017 to Dec 2017, 260 school going children of the age (6 to 9 years) with NE were prospectively assessed using ESPQ test profile. Of the 13 paired parameters 64.74 % of the children were COOL, 94% had concrete thinking, 97% were affected by feelings, 91% were dominant, 97% were shy and 91% were guilt prone. When gender differences were done 91% of the males were warm as compared to 8% in females. 58% of the male were dominant as compared to 41% of the females and 40% of the males were guilt prone as compared to 60% females.

CONCLUSIONS

NE has negative effects on the self-image and performance on children.  Perceived competence was lower in girls than in boys with enuresis, and it was significant than in the higher age than in lower. Children with day time and night-time incontinence have a significantly decreased competence on scholastic skills compared to children with nocturnal problems only. 


10:40 - 10:50
S1-3 (LO)

SENS-U™: CONTINUOUS HOME MONITORING OF NOCTURAL BLADDER FILLING IN CHILDREN WITH ENURESIS - A FEASIBILITY STUDY

W.M.J. KWINTEN 1, P.G. VAN LEUTEREN 1, M. VAN DUREN - VAN IERSEL 2, P DIK 1 and P JIRA 2
1) Wilhelmina Children's Hospital UMC Utrecht, Pediatric Urology, Utrecht, NETHERLANDS - 2) Jeroen Bosch Hospital, Department of Pediatrics, 's-Hertogenbosch, NETHERLANDS

INTRODUCTION

Enuresis is a common problem in school-age children; 5-10% suffer from this condition. One of the treatment options is alarm therapy which uses a wetting alarm to teach pelvic floor contraction when incontinence occurs. However, a disadvantage of this approach is that the child is still awaken by wet sheets. Recently, a new, wearable ultrasonic bladder sensor became available, the SENS-U™ Bladder Sensor, which has the potential to prevent the enuretic event by waking up the child before the bladder is full. In this study, the aim is to perform a home-based evaluation of the SENS-U during the night in children with nocturnal enuresis.

PATIENTS AND METHODS

In this study, 15 children (6-12 years) with monosymptomatic nocturnal enuresis were included for a monitoring session at home for one night. Before bedtime, the SENS-U was positioned by the researcher. During the night, the SENS-U estimated the filling status (i.e. every 30 s), while notifications were deactivated.   In addition, urine volume was collected in a measurement cup (or diaper weight). The next morning, the SENS-U was removed by the researcher and SENS-U data was stored for off-line processing. The total number of measured nocturnal bladder filling cycles was analyzed by descriptive statistics.  

PRELIMINARY RESULTS

At this moment, 8 patients (boys/girls: 7/1) [mean age: 8.4 ± 1.3 years, range: 7 – 11 years] are included in the study. The first results show that the SENS-U is able to monitor the changes in bladder size overnight, due to the increase of bladder volume. Next, none of the patients experienced any difference in their sleep habit’s as result of wearing the SENS-U.

CONCLUSIONS

Based on the first results, the SENS-U™ Bladder Sensor is a feasible approach for monitoring the nocturnal bladder filling. Future research will focus on investigating the response to receiving a full-bladder notification during the night.


10:50 - 11:00
S1-4 (LO)

SOCIOECONOMIC AND FAMILIAL ASPECTS OF CHILDREN WITH BED WETTING

Neeraj DIXIT 1, Shridhar GHAGANE 1, Mubhashir ANAGOLKAR 2, Veeresh B 2 and Rajendra NERLI 1
1) KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Urology, Belagavi, INDIA - 2) JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Public Health, Belagavi, INDIA

PURPOSE

Enuresis is a health problem frequently encountered in childhood. This study was carried out to study the prevalence, socioeconomic and familial aspects of children presenting with Bed wetting (Nocturnal Enuresis) in Urban areas of South India.

MATERIAL AND METHODS

The study included children (Age 6 to 10 years) presenting with symptoms of bed wetting. A detailed history included questions regarding socioeconomic status of the family.

RESULTS

During the study period Jan 2017 till Dec 2018, a total of 405 school going children presented to the bed wetting clinic with complaint of nocturnal enuresis. 31 % of the children aged 7 years and 13.3% were 8 year old. 33.3% of the children were females and 66.7% were male. 51.1% of the children were the first born and 37.8% were second born in the family. 44% of the children had fathers who were educated upto secondary school level and the similar number were educated upto graduate level.  97.8% of the fathers were working as compared to 22% of the mothers. 46.7% of the children came from nuclear families as compared to 51% of the children from joint families. 62% of the children had Nocturnal enuresis and 37% of the children had both day and night time enuresis. 60% of the children had enuresis daily. 13% of the children also complaint of the constipation. 62% of the children did not seek treatment previously. 57.8% of the children performed well in school and 13.3% performed poorly in school. 62% of the parents felt that this problem brought extra financial burden and 51% of the parent complained of stress in the family.

CONCLUSIONS

Nocturnal enuresis is a source of stress, extra finaicial burden and a matter of hygine to the family. There was no relation between education of the father, mother, working status of the parents, type of family with prevalence of bed wetting