ICCS & ESPU-Nurses Meeting on Wednesday 3, September 2025, 14:30 - 15:00
14:30 - 14:36
SN01-1 (OP)
Antonio MARTINELLI BRAGA, Jason VAN BATAVIA, Shailee SHROFF, Stephen ZDERIC, Monica MORAN, Marianne NAZAREWYCZ, Joy KERR, Laurabeth MCALLISTER and Katherine FISCHER
Children's Hospital of Philadelphia, Urology, Philadelphia, USA
PURPOSE
Sex differences in lower urinary tract physiology and pelvic muscle control are documented in the literature. These distinctions raise questions about their influence on the manifestation and severity of urinary symptoms. Therefore, the aim of this study is to analyze possible differences between pediatric males and females in Lower Urinary Tract Symptoms (LUTS) at baseline and LUTS intensity prior to biofeedback therapy.
MATERIAL AND METHODS
This is a retrospective cohort study involving children with Lower Urinary Tract Disfunction (LUTD) that were treated with biofeedback between 2013 and 2024. Patients with incomplete data were excluded. The questionnaire used was the Dysfunctional Voiding and Incontinence Scoring System (DVISS) to assess LUTS intensity. Pre-treatment symptoms and pre-treatment DVISS scores were compared between sexes.
RESULTS
We included 575 patients in the study, 391 (68.0%) females, with a mean age of 8.62 ± 3.20. In the analysis of the association between sex and pre-treatment symptoms, males were more likely to have developmental or neurological diagnosis prior to treatment (M=23; F=19; p<0.001) and hematuria (M=10; F=6; p=0.014). In contrast, females were more prone to have frequency (F=85; M=58; p=0.041); Stress incontinence (F=13; M=1; p=0.034); Constipation (F=188; M=76; p=0.033); Urinary tract infections (UTIs) (F=230; M=20; p<0.001) and use of antibiotic prophylaxis (F=120; M=7; p<0.001). The initial DVISS score (Female = 12.79 ± 6.55; Male = 12.49 ± 6.91; p=0.618) did not differ between sexes.
CONCLUSIONS
Females are more likely to have specific LUT symptoms such as, frequency, stress incontinence, constipation, UTIs. In comparison, males are associated with developmental or neurological diagnosis and hematuria. LUTS intensity prior to biofeedback did not differ between groups.
14:36 - 14:42
SN01-2 (OP)
Claire FOSTER 1, Anna PAGE 2 and Arash TAGHIZADEH 1
1) Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation trust, Paediatric Urology, London, UNITED KINGDOM - 2) Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation trust, Paediatric Bladder, London, UNITED KINGDOM
PURPOSE
Dysfunctional voiding (DV) is associated with symptoms of urinary incontinence (UI) and urinary tract infection (UTI). Pelvic floor biofeedback training is used as a treatment for DV in children, however outcome data is limited. We reviewed the long-term efficacy of biofeedback for DV in a large cohort of children.
MATERIAL AND METHODS
Retrospective single centre review of patients with DV (defined by voiding staccato flow with pelvic EMG activity) who received biofeedback training with pelvic floor EMG (Urostym, Laborie) between 2017-2022. Patients with structural abnormality and neurogenic bladder were excluded. Primary outcome measures were the presence of UI and UTI, assessed prior to treatment (Pre), at end of treatment (EoT) and at follow-up closest to 1 year after completing treatment (1YFU). Data given as median (IQR). Statistical methods: Wilcoxson test for numerical and McNemar's for categorical data.
RESULTS
Of the 238 patients that completed biofeedback, 84.5% were female, with a mean age 11 (9.35-13.18) years, Data for 1YFU was available for 185.
Treatment was across median 4 sessions, delivered over 84 (63-149.25) days with follow-up over 13 (10.72-18.84) months. UI was present at Pre in 192 (80.7%) and was significantly (P <.001) reduced by EoT in 153 (64.3%) and at 1YFU 83 (44.8%). UTI was present at Pre in 125 (52.5%) and significantly (P <.001) reduced by EoT in 33 (13.9%) and at 1YFU in 29 (15.7).
CONCLUSIONS
In this large cohort with DV, pelvic floor biofeedback training results in significant and sustained improvement in UI and UTI.
14:42 - 14:48
SN01-3 (OP)
Damla KORKMAZ DAYICAN 1, Büşra PALAZ 2, Ali TEKİN 3, Sibel TİRYAKİ 3, İbrahim ULMAN 3, Ezgi ALTUN TANIL 3 and Özge ÇELİKER TOSUN 4
1) İzmir Tınaztepe University, Physiotherapy and Rehabilitation, Izmir, TÜRKIYE - 2) İzmir Bakırçay University, Physiotherapy and Rehabilitation, Izmir, TÜRKIYE - 3) Ege University, Pediatric Surgery, Izmir, TÜRKIYE - 4) Dokuz Eylül University, Physiotherapy and Rehabilitation, Izmir, TÜRKIYE
PURPOSE
Sensory profile differences and sensory processing dysfunction can be observed in children with urinary incontinence. The effect of pelvic floor muscle training (PFMT) on pelvic floor muscles is known; however, its impact on sensory profile remains unclear. This study aimed to investigate the effects of a multimodal PFMT on sensory profile, sensory processing skills, and core muscle functions in children with urinary incontinence.
MATERIAL AND METHODS
Twenty children with urinary incontinence were randomized into a multimodal PFMT plus routine treatment group and a routine treatment only group. The multimodal PFMT was performed for 60 minutes per week for 10 weeks. The children's sensory profile [Adolescent/Adult Sensory Profile (AASP) and the Interoception Sensory Questionnaire (ISQ)], sensory processing skills [Sensory Processing Scale (SPS)], lower urinary tract symptoms [Dysfunctional Voiding and Incontinence Scoring System (DVISS), Bladder and Bowel Dysfunction Questionnaire (BBDQ), Childhood Bladder and Bowel Dysfunction Questionnaire (CBBDQ)], and core muscle functions (ultrasound imaging) were evaluated.
RESULTS
A significant reduction was observed in AASP total score (p=0.047) and all sub-dimensions, ISQ total score and SPS all sub-dimensions. The DVISS, BBDQ, and CBBDQ scores significantly decreased (p=0.005), most in daytime urinary frequency symptoms (80.0%). Additionally, 70% of the children showed a decrease in pelvic floor muscle tone. There was also an increase in thickness of the transversus abdominis (p=0.005), internal and external oblique abdominal muscles (p=0.007), and diaphragm displacement (p=0.021).
CONCLUSIONS
Multimodal PFMT may affect the sensory profile, sensory processing skills, and core muscles in children with urinary incontinence, particularly in terms of sensory sensitivity.
14:48 - 14:54
SN01-4 (OP)
Laura LITTLEJOHN
Riley Children's Hospital with IU Health, Pediatric Urology, Indianapolis, USA
PURPOSE
This study aims to evaluate the efficacy of a pilot virtual group seminar regarding dysfunctional voiding. This is offered for families of children 5-8 years of age with symptoms including dysuria, frequency, urgency and incontinence. This is provided at no cost, and families are encouraged to schedule an in-person appointment if symptoms persist after implementing modifications, or if their child has urinary tract infections.
MATERIAL AND METHODS
A forty-five minute telehealth seminar takes place bi-monthly. Dysfunctional voiding basics are reviewed and families are provided non-pharmacologic management centered around changing behaviors. The intention is to provide practical first steps to improve symptoms and identify high risk patients needing in-person evaluation. Surveys are administered online immediately after session completion. Attendees who scheduled an appointment after the session were monitored and seen in clinic by one of three seasoned nurse practitioners, all of whom were interviewed after the visits.
RESULTS
Over nine group sessions, 44 families attended the seminar and 48% completed the evaluation survey. Eighty-one percent of families strongly agreed that the session provided helpful information.
Sixty-four percent of attendees scheduled in person appointments. Patients were seen by one of three seasoned nurse practitioners, all of whom reported families were better prepared for their first visit (specifically, families utilized voiding diaries and worked to improve constipation prior to visit).
CONCLUSIONS
A virtual group seminar can be a useful tool in empowering caregivers to take first steps in management of voiding dysfunction. Families find it helpful and healthcare providers report families are better prepared for their first visit.
14:54 - 15:00
SN01-5 (OP)
Büşra PALAZ 1, Damla KORKMAZ DAYICA 2, Ali TEKİN 3, Sibel TİRYAKİ 3, İbrahim ULMAN 3, Ezgi ALTUN TANIL 3 and Özge ÇELİKER TOSUN 4
1) İzmir Bakırçay University, Physiotherapy and Rehabilitation, İzmir, TÜRKIYE - 2) İzmir Tınaztepe University, Physiotherapy and Rehabilitation, İzmir, TÜRKIYE - 3) Ege University, Pediatric Surgery, İzmir, TÜRKIYE - 4) Dokuz Eylül University, Physiotherapy and Rehabilitation, İzmir, TÜRKIYE
PURPOSE
It has been reported that children with urinary incontinence may experience impairments in certain sensory feedback mechanisms (such as auditory, tactile, and vestibular processing). Therefore, this study aimed to investigate whether sensory profiles and sensory processing skills differ according to the type of urinary incontinence in children.
MATERIAL AND METHODS
This prospective study included 20 children with urinary incontinence. Of these, 13 (65%) were female, and 7 (35%) were male, with a mean age of 8.84±2.67 years. Fourteen had bladder bowel dysfunction (BBD) (65%), six had monosymptomatic enuresis (Group 1). Patients with BBD were further divided into two groups as with (group 2, 7 patients) and without enuresis (group 3, 7 patients). The children's sensory profiles were assessed using the Interoception Sensory Scale (ISS), the Dunn Sensory Profile (DSP) for children under 10 years old, and the Adolescent/Adult Sensory Profile (AASP) for those over 10 years old. Sensory processing skills were evaluated with the Sensory Processing Scale (SPS).
RESULTS
Children in group 1 had significantly lower total and subscale scores on the ISS, AASP, DSP, and SPS compared to those in other two groups (p=0.04). When evaluating all sensory profiles and sensory processing skills, children in group 2 had the highest scores (p=0.02).
CONCLUSIONS
Differences in sensory profiles and sensory processing were observed among children with different types of urinary incontinence. Notably, children with BBD having both daytime and nighttime incontinence appeared to be the most affected by sensory dysfunction.