ESPU-Nurses Meeting on Thursday 18, April 2024, 15:30 - 16:00
15:30 - 15:40
SN5-1 (OP)
Lola BLADT 1, Vanhoutte NELE 1, Dante TEUGELS 1, Elien WILLE 1, Thomas DE JONGH 1, Lukas VAN CAMPENHOUT 1, Gunter DE WIN 2 and Alexandra VERMANDEL 2
1) University of Antwerp, Product Development, Antwerp, BELGIUM - 2) University Hospital Antwerp, Urology, Edegem, BELGIUM
PURPOSE
Approximately 1 in 5 children experience toileting refusal for bowel movements, which can lead to stool withholding and constipation. Previous generations in Belgium used a feeding chair with a bottom opening for feces collection, allowing children to experience bowel movements without a diaper during meals by exploiting the gastro-colic reflex. Despite its potential benefits, the potty feeding chair has largely disappeared from use. The aim of this study was to identify the potential reasons behind its disappearance and decline in popularity.
MATERIAL AND METHODS
We conducted 8 face-to-face interviews and gathered online survey responses from 121 recent parents with at least one child under the age of 7. Among the survey respondents, the majority were female (93%), and a significant portion fell within the 25-35y age range (54%).
RESULTS
Most respondents (67%) expressed reluctance to use the potty feeding chair, primarily due to concerns about the lack of separation between eating and toileting (80% mentioning it as one of their top 3 concerns), hygiene (78%), and smell (74%). While a child wearing a diaper can also experience bowel movements during a meal, some parents may misinterpret the potty feeding chair as a replacement for a potty to teach appropriate toileting behavior. Instead, it should be seen a as a preparatory tool for potty training to help children get accustomed to the sensation of a bowel movement without a diaper. Notably, this aligns with the top perceived benefits of the chair, including experiencing this sensation of a bowel movement without a diaper (mentioned by 64% as one of their top 3 benefits), ease of use (62%) and prevention of constipation (58%).
CONCLUSIONS
Our research indicates reluctance to use the potty feeding chair. However, redesigning it to address parental concerns and raise awareness about its intended purpose holds promise for preventing pediatric bowel problems and facilitating toilet training.
15:40 - 15:50
SN5-2 (OP)
Anastasia GLIATIS, Kristina GAM, Katherine STAHOVIAK and Mohan GUNDETI
University of Chicago, Surgery, Urology, Chicago, USA
PURPOSE
For patients with an overactive bladder refractory to medical management, intravesical injection of Botulinum Type-A Toxin (BTX-A) has become a treatment option. One potentially serious complications of BTX-A that is pre-operatively discussed with patients/parents is the risk of urinary retention with the possible need for intermittent catheterization for an extended period, following the procedure. Other side effects are urinary tract infection and hematuria. The aim of this study is to determine if urinary retention is a true risk of BTX-A injection procedure.
MATERIAL AND METHODS
19 pediatric patients with a diagnosis of neurogenic bladder or non-neurogenic neurogenic bladder, who had failed medical management, were included in this study. Chart review for indications, operative reports, voiding diaries, Urodynamics/Uroflow studies, and side effects were reviewed.
Each patient had between 1-6 injections, based on their symptoms and Urodynamics results.
RESULTS
A total of 100 injections were performed with follow-up ranging from 4-185 months.
None had urinary retention following BTX-A injection, in this study.
|
Patient Data |
# of Patients |
|
Total patients |
19 |
|
Total injections at single center |
100 |
|
Average time for patient follow-up |
65.32 months |
|
Patients with dx neurogenic bladder |
11 (58%) |
|
Patients with non-neurogenic bladder/idiopathic |
8 (42%) |
|
Patients previously managed with anticholinergic medications |
19 (100%) |
|
Bladder capacity average % change |
135.3mL |
|
Resolution of daytime symptoms |
17 (89%) |
|
Side effects after BTX-A injection |
|
|
UTI |
3 (15%) |
|
Urinary retention |
0 (0%) |
|
Hematuria |
0 (0%) |
CONCLUSIONS
Urinary retention was not a side effect of the BTX-A procedure, in our patient population. The most common was a UTI. There is a scope for revisiting the counseling for these patients, as possible urinary retention does raise anxiety in most patients/families.
15:50 - 16:00
SN5-3 (OP)
Lola BLADT 1, Anka NIEUWHOF-LEPPINK 2, Rose-Farah BLOMME 1, Gunter DE WIN 3, Alexandra VERMANDEL 3 and Lukas VAN CAMPENHOUT 1
1) University of Antwerp, Product Development, Antwerp, BELGIUM - 2) Wilhelmina Children's Hospital, UMC Utrecht, Urology, Utrecht, NETHERLANDS - 3) University Hospital Antwerp, Urology, Edegem, BELGIUM
PURPOSE
Urotherapy is the recommended first-line treatment for children with lower urinary tract symptoms, but patient compliance and motivation are low. The traditional urotherapy supporting products are often paper-based solutions with limited use of modern technology. The objective is to gain a deeper understanding of the experiences, needs, and desires of pediatric patients in regards to urotherapy supporting products.
MATERIAL AND METHODS
Qualitative research was conducted using focus groups and co-creation techniques with children following in-hospital urotherapy group training. Children actively participated in a variety of creative exercises, including crafting collages to express personal experiences, providing feedback on both existing and innovative urotherapy products through pen and paper exercises, and drawing a superhero who, like them, happens to have a bladder problem. With consent, all sessions were recorded for thematic analysis.
RESULTS
A total of 7 sessions were conducted with 5 groups of children (N=19; M:13, F:6; age range 9-13y), lasting 1.5 to 2 hours each. Important findings were the influence of peers, the changing context of product use (e.g. home versus school), and the intrinsic motivations portrayed through different superhero traits. These included superpowers to make bullies wet their pants, a diaper man with an unlimited diaper supply, a superhero with a wetting alarm and gender-specific accessories with superpowers to prevent urination while wearing them. Furthermore, children recognized the value of the urotherapy supporting products, yet identified opportunities for improvement, like incorporating gamification and smart technology to increase their appeal and motivation for usage. These desires align with their positive feedback on innovative ideas, such as a urotherapy ecosystem comprising interconnected products for monitoring both fluid intake and output, employing smart and engaging alerts.
CONCLUSIONS
These findings highlight the importance of considering social dynamics, environmental contexts, individual motivations and child engagement in the design and selection of urotherapy products.