ESPU Meeting on Friday 10, June 2022, 08:10 - 08:40
08:10 - 08:13
S10-1 (OP)
Britt BORG 1, Konstantinos KAMPERIS 2, Søren RITTIG 2 and Rene Frydensbjerg ANDERSEN 2
1) Aarhus University Hospital / Ferring Pharmaceuticals, Child and Youth Medicine, Aarhus, DENMARK - 2) Aarhus University Hospital, Child and Youth Medicine, Aarhus N, DENMARK
PURPOSE
Behavior regarding toilet visits seems related to symptoms of BBD. We therefore investigated the effect of school lockdown during the Covid-19 pandemic on BBD, thus mimicking an environmental intervention during treatment.
MATERIAL AND METHODS
We examined the effect of school lockdown in January 2021 on BBD by sending structured questionnaires regarding patient reported outcomes to a cohort receiving treatment from a hospital-based outpatient clinic.
RESULTS
106 parents completed the questionnaire. 83 % of the children received remote computer-based learning at home during the lockdown, 17 % of the children were still at school. For children with DUI receiving remote learning 64,3 % reported improvement of symptoms during lockdown compared to 33,3 % of the children who were at school. On the Childhood Bladder Bowel Disease questionnaire, the frequency of symptoms score was significantly lower in children with DUI receiving remote learning compared to children at school, 30,9 points (29.0 ; 32.9) vs 36,1 points (30.6 ; 41.5), p<0.05. 54-56 % of parents answered that "fluid and toilet habits" or "psychosocial factors" had "some" to "a very high degree" of influence on the child's incontinence symptoms. Parent support regarding habits and that the children did not miss out on social activities by going to the toilet were the most important factors according to parents.
CONCLUSIONS
More children with DUI receiving remote learning at home during lockdown had lower frequency of symptoms reported on the CBBD questionnaire. This study suggest that with improved support for the children at school their symptoms could be improved.
08:13 - 08:16
S10-2 (OP)
Ece Zeynep SAATCI 1, Halil TUGTEPE 2, Aygul KOSEOGLU 3, Tugce ATALAY 3 and Ebru KAYA MUTLU 4
1) Private Tugtepe Pediatric Urology Center, Institude of Graduate Studies Istanbul University-Cerrahpasa, Division of Bladder & Bowel Dysfunction, Division of Physiotherapy and Rehabilitation,, Istanbul, TURKEY - 2) Private Tugtepe Pediatric Urology Center, Istanbul, TURKEY - 3) Private Tugtepe Pediatric Urology Center, Division of Bladder & Bowel Dysfunction, Istanbul, TURKEY - 4) Bandirma 17 Eylul University, Faculty of Health Sciences, Physiotherapy and Rehabilitation, Balikesi̇r, TURKEY
INTRODUCTION
The thalamus, pons, bulbar and reticular formation areas are responsible for the control mechanism of continence also postural stability and control. Therefore, it is thought that trunk muscles and lower extremity alignment related to postural stability may be adversely affected in children. In current clinical practice, posture and balance changes have been noticed during physiotherapy assessments in children and adolescents with incontinence. This study aimed to examine trunk and lower extremity biomechanics among children with lower urinary system dysfunction (LUTD).
MATERIAL AND METHODS
Voluntary participants meeting inclusion criteria were divided into two groups: LUTD group (n=43) and control group (n=43). No treatment applied to participants and same evaluation methods used in both groups. Strength and endurance of trunk muscles, posture and pelvic floor muscle activity of participants was evaluated with stabilizer pressurized biofeedback unit, Sit-ups and Modified Push-ups Test; trunk flexors and extensor endurance tests, Posture Screen Mobileapp and Beighton Score for generalized hypermobility; and NeuroTrac-Myoplus4Pro device, respectively.
RESULTS
It was found that LUTD group had weaker transversus abdominis muscle (p=0.001) and less trunk muscle endurance (p=0.004, p=0.08). Also curvatures of head (p=0.001), shoulder (p=0.018) and hip (p=0.002) and displacement of knees (p=0.002) were increased. Beighton’s score of LUTD group (p=0.037) was higher.
CONCLUSIONS
Consequently, alterations were found in trunk and lower extremity biomechanics of LUTD group compared to healthy children. It was demonstrated that transversus abdominis muscle strength, trunk muscle endurance and some posture parameters were lower than the control group. Therefore, biomechanical evaluation of the trunk and lower extremities by physiotherapists in children with LUTD is important for the treatment method to be planned.
08:16 - 08:19
S10-3 (OP)
Hrair-George MESROBIAN 1, Jonathan ELLISON 2, Aushja SYED 3, Jody BARBEAU 4, Katja KOVACIC 5 and Manu SOOD 5
1) Children's Hospital of Wisconsin, Urology, Milwaukee, USA - 2) Children's Hospital of Wisconsin, Miwaukee, USA - 3) Medical College of Wisconsin, Urology, Milwaukee, USA - 4) Medical College of Wisconsin, Quantitative health research, Milwaukee, USA - 5) Children's and Medical College Wisconsin, Gastroenterology, Milwaukee, USA
PURPOSE
Sacral Neuromodulation (SNM) has become a successful treatment modality in children with urinary and or fecal incontinence if standard medical therapy has failed. During the course of their work up, these patients are not found to have neurologic anomalies of the lumbosacral spinal cord. Since sacral bony anomalies can be associated with incontinence, we reviewed spinal imaging in children undergoing SNM. We hypothesized that more subtle parameters describing the relative position and spatial arrangements of the bony structures in these patients may differ from continent individuals
MATERIAL AND METHODS
Following IRB approval, we prospectively reviewed a database of children who presented for SNM. 21 unique elements of symptoms and past treatment had to be documented for inclusion. The following parameters were measured: Sacral Slope (SS), Pelvic Tilt (PT), Pelvic Incidence (PI) and Sacral Ratio (SR), thereby measuring pelvic and sacral morphologic properties in the sagittal (MRI) and anterior planes (KUB). Each variable was measured twice by two of the authors (HGM and AS) in each patient. The average value of each measurement was then compared to well established and matched values in continent children. We derived a 2 tailed t test P value of significance of the mean and standard deviation in each group.
RESULTS
Of 75 children evaluated for SNM, 39 (21 girls and 18 boys) underwent a staged procedure. The mean age at surgery was 13 years and Follow up averaged 2 years (2-6). The results show a statistically significant difference in PI and SR compared to continent individuals
|
|
SNM |
Control |
P value |
|
SS |
45± 5.55° |
41.4± 8.2° |
0.0834 |
|
PT |
10 ± 4.20° |
7.7 ± 8° |
0.2660 |
|
PI |
40.83± 8.31° |
49.1± 11° |
0.0032* |
|
SR |
0.54± 0.09 |
0.74 ± 0.16 |
0.0001* |
CONCLUSIONS
These measures of pelvic alignment and sacral development differ significantly from normal in this subgroup of patients. Pending further study, these parameters may identify those patients with incontinence who would benefit from early referral for SNM.