ICCS & ESPU-Nurses Meeting on Wednesday 3, September 2025, 15:30 - 16:18
15:30 - 15:36
SN02-1 (OP)
Büşra PALAZ 1, Damla KORKMAZ DAYICAN 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
Sensory function impairment and core muscle dysfunction can be observed in children with lower urinary tract symptoms (LUTS). The purpose of this study was to explore the connections between sensory profiles, sensory processing, and core muscle function in children with LUTS.
MATERIAL AND METHODS
This prospective study included 20 children with LUTS, with a mean age of 8.84±2.67 years. Sensory profiles were assessed using the Interoception Sensory Scale (ISS), Dunn Sensory Profile (DSP), and the Adolescent/Adult Sensory Profile (AASP). Sensory processing skills were evaluated using the Sensory Processing Scale (SPS). Core muscle activity was assessed with ultrasonography and electromyography (EMG).
RESULTS
A positive correlation was found between the balance and movement scores and core muscle thickness. A negative correlation was noted between pelvic floor displacement and two DSP sub-profiles. Additionally, the planning and ideation had a positive correlation with pelvic floor muscle EMG activity. A positive correlation was observed between the sensory sensitivity and core muscle EMG parameters. A positive correlation also emerged between BBDQ scores and the auditory processing subscale of the SPS.
|
|
Balance and Movement[r(p)] |
|
TA–RMT |
0.54(0.02) |
|
TA–CMT |
0.51(0.03) |
|
RA–RMT |
0.47(0.05) |
|
EO–RMT |
0.77(0.001) |
|
EO–CMT |
0.68(0.002) |
|
|
Pelvic Floor Displacement[r(p)] |
|
Tactile Processing |
-0.63(0.04) |
|
Multisensory processing |
-0.75(0.01) |
|
|
Adolescent/Adult Sensory Profile-Sensory Sensitivity[r(p)] |
|
PFM – Rest Deviation |
0.74(0.01) |
|
TA–Rest Maximum Voluntary Contraction |
0.63(0.03) |
|
DF–Rest Average |
0.70(0.01) |
|
MM–Rest Average |
0.64(0.04) |
|
TA:transversus abdominis, RMT:Resting muscle thickness, CMT:Contraction muscle thickness, EO:external obliques, PFM:pelvic floor muscles. |
|
CONCLUSIONS
LUTS in children appear to be associated with sensory function and core muscle activity. Further research is needed to fully understand this relationship.
15:36 - 15:42
SN02-2 (OP)
Ahmed HASSAN 1, Hayley WYNNE 2, Ella POLLITT 2 and Anju GOYAL 2
1) Manchester University NHS Foundation Trust, Paediatric urology, Manchester, UNITED KINGDOM - 2) Manchester University NHS Foundation Trust, Paedaitric Urology, Manchester, UNITED KINGDOM
PURPOSE
Overactive bladder (OAB) refractory to anti-cholinergics is a challenging condition and requires paediatric urology services and specialist nursing support for years. After transition to adult services, progression remains unclear. This study evaluated long-term outcomes.
MATERIAL AND METHODS
48 patients/parents who had participated in a RCT 10 years earlier and had urodynamically proven refractory OAB with day time wetting were invited to complete a questionnaire.
RESULTS
Median age at presentation with OAB was 7.0 years(range:3.0–15.0). All were refractory to anti-cholinergics and underwent urodynamic study (UDS) a median of 2.0 years later. After confirmation of bladder overactivity, interventions included anti-cholinergics only(5), Botulinum toxin(32), or Mirabegron(11) as a single or combined therapy.
The telephone questionnaire was completed by participants at a current median age of 18.0 years(range:15.0–23.0).
20 patients (41.7%) were symptom-free, and 14 patients (29.2%) had some urgency with no significant impact on quality of life. Another 3(6%) had mild OAB symptoms.
11 had moderate-to-severe OAB symptoms but only 6 were taking medication (4 under adult services). 42 patients (87.5%) were off medication. 39 patients (81.3%) expressed great satisfaction with paediatric urology/nursing services.
CONCLUSIONS
Despite an often long and frustrating journey in refractory OAB, long term outcome is encouraging with 77% patients having complete or near complete symptom resolution. 23% have persistent significant symptoms but half do not seek appropriate help, highlighting the need for a robust transition pathway. Moreover, the high satisfaction rate with our paediatric urology services demonstrates the importance of a patient-centred, multidisciplinary approach.
15:42 - 15:48
SN02-3 (OP)
Anka J. NIEUWHOF-LEPPINK 1, Eline H.M. VAN DE WETERING 2, André B. RIETMAN 3, Anita REINDERS-VAN ZWAM 4 and Renske SCHAPPIN 5
1) Wilhelmina Children's Hospital, University Medical Center Utrecht, Department of Medical Psychology and Social Work, Utrecht, NETHERLANDS - 2) Radboudumc, Paediatric Urology, Nijmegen, NETHERLANDS - 3) Sophia Children's Hospital, Erasmus Medical Center, Department of Child and Adolescent Psychiatry/Psychology, Rotterdam, NETHERLANDS - 4) Psychotherapy Bartiméus, Department of Mental Health Care, Doorn, NETHERLANDS - 5) Erasmus Medical Centre, Department of Dermatology, Rotterdam, NETHERLANDS
PURPOSE
Functional daytime urinary incontinence (DUI) is a frequently occurring condition among children, with a multifactorial etiology. Autism Spectrum Disorder (ASD) seems related to DUI, as children with ASD have a higher risk of developing DUI. Sensory processing issues are prevalent in children with ASD and may contribute to DUI. This study aims to elucidate the role of sensory processing in children with DUI, in relation to ASD.
MATERIAL AND METHODS
A cross-sectional study was conducted, including parents of children aged 6-12 years old, categorized into four groups: healthy children, children with DUI-only, children with ASD-only, and children with both DUI and ASD. Parents completed the Dutch version of the Short Sensory Profile (SSP-NL) to compare sensory processing between groups.
RESULTS
A total of 225 eligible children participated in this study, with 75 healthy children, 58 children with DUI-only, 49 with ASD-only, and 43 children with DUI and ASD. Children with DUI-only scored significantly lower compared to their healthy peers in the SSP-NL domain ‘Low energy/weak’ and the quadrant ‘Low registration’, indicating sensory under-responsivity and potential limitations in multisensory processing. Children with ASD had the most sensory processing issues, independent of their DUI-status.
CONCLUSIONS
Our study found that children with DUI may have impairments in multisensory processing and sensory under-responsivity, compared to their healthy peers. These findings suggest that some children may have an impaired perception of bladder signals, potentially contributing to the development of DUI. A more comprehensive understanding of the associated issues with incontinence may improve urotherapy considering children’s potential sensory challenges and teaching them adaptive behavior.
15:48 - 15:54
SN02-4 (OP)
Melis ÜNAL 1, Ece Zeynep SAATÇI 1, Tuğçe OSKAY 1, Dilara Damla KALIN 1, Tuğba KURT 1 and Halil TUĞTEPE 2
1) Uropelvic Solutions Pelvic Floor Rehabilitation Center, Pediatric Urology, İstanbul, TÜRKIYE - 2) Tuğtepe Pediatric Urology and Surgery, Pediatric Urology, İstanbul, TÜRKIYE
PURPOSE
Bladder control during sleep involves pelvic floor muscle (PFM) activation, which inhibits the detrusor muscle. In nocturnal enuresis (NE), this reflex arc may be disrupted, causing insufficient detrusor inhibition and PFM activation.This retrospective study aimed to compare PFM functional status, activation, rehabilitation session numbers, and alarm response weeks in children experiencing different frequencies of NE within a single night.
MATERIAL AND METHODS
The study included 82 children:38 in Group-A (NE once per night) and 44 in Group-B (NE twice or more per night). PFM rehabilitation sessions were terminated upon a complete response per ICCS criteria. PFM activation was assessed via surface electrodes with a NeuroTrac-MyoPlusPro device, and function was evaluated through external palpation of the external anal sphincter by a physiotherapist. Rehabilitation session numbers and alarm response weeks were also compared between the groups.
RESULTS
Physical and demographic characteristics were similar between groups (p>0.05). In Group-A, PFM function was overactive in 21,underactive in 10, functional in 7. In Group-B, it was overactive in 17,underactive in 13,functional in 10, and non-functional in 1. No significant differences were observed between groups in PFM activation parameters,alarm response weeks, or rehabilitation session numbers (p>0.05)(Table 1).
|
Parameters |
Group-A |
Group-B |
p |
|
PFM Work Average(µV) |
6.96±3.64 |
7.38±4.16 |
0.752 |
|
PFM Work Average Deviation(%) |
32.99±9.65 |
36.64±10.92 |
0.088 |
|
PFM Work Maximum Voluntary Contraction |
35.41±11.03 |
35.08±8.45 |
0.734 |
|
Alarm response weeks(n) |
2.13±2.58 |
2.27±2.04 |
0.398 |
|
Rehabilitation session(n) |
9.47±3.47 |
10.14±3.93 |
0.438 |
*Daha expressed Mean ± Standard Deviation, Mann Whitney-U Test *p<0.05
CONCLUSIONS
PFM functionality may not directly affect NE frequency,nor does NE frequency influence alarm response weeks or PFM rehabilitation sessions. These findings highlight the importance of individualized treatment approaches that address broader physiological and behavioral factors beyond PFM functionality to achieve optimal outcomes in children with NE.
15:54 - 16:00
SN02-5 (OP)
Ece Zeynep SAATÇI 1, Tuğçe OSKAY 1, Melis ÜNAL 1, Tuğba KURT 1, Dilara Damla KALIN 1 and Halil TUGTEPE 2
1) Uropelvic Solutions Pelvic Floor Rehabilitation Center, Pediatric Urology, Ataşehi̇r, TÜRKIYE - 2) Tugtepe Pediatric Urology Clinic, Pediatric Urology, Istanbul, TÜRKIYE
PURPOSE
This study assesses the differences in pelvic floor muscle (PFM) function before and after treatment in children with MNE and NMNE. It also evaluates the impact of treatment duration, session frequency, and clinical parameters on treatment outcomes.
MATERIAL AND METHODS
A total of 24 children with MNE and 58 with NMNE participated. PFM strength was evaluated using the Modified Oxford Scale, and muscle activation was measured via EMG biofeedback. Treatment session count, muscle strength, activation, and clinical data (such as enuresis frequency, alarm reactions) were assessed pre- and post-treatment.
RESULTS
•Treatment Duration and Session Frequency: The MNE group received fewer sessions (mean:8.38) compared to the NMNE group (mean: 10.43), with a significant difference (p=0.012), indicating faster treatment completion in the MNE group.
•Pelvic Floor Muscle Function: Both groups showed improvement, with MNE showing 100% and NMNE 98.3% improvement. However, the differences between the groups were not statistically significant (MNE: p=0.26, NMNE: p=0.096).
•Clinical Parameters: Although the MNE group had a lower baseline enuresis frequency(p=0.001), both groups showed similar improvements in clinical outcomes. No significant differences in post-treatment clinical outcomes were observed between the groups (p>0.05).
CONCLUSIONS
PFM rehabilitation proved to be similarly effective for both MNE and NMNE. The MNE group required fewer treatment sessions and completed treatment more rapidly, likely due to the absence of associated LUTD. Notably, the lack of significant baseline differences between the groups further highlights the effectiveness of PFM rehabilitation in improving muscle function. PFM rehabilitation is a valuable and effective therapeutic approach for managing NE in children, irrespective of the presence of coexisting urinary symptoms.
16:00 - 16:06
SN02-6 (OP)
Bieke SAMIJN 1, Amy DE ROUBAIX 2, Mathilde JOOS 2, Lynn BAR-ON 2, Christine VAN DEN BROECK 2, Luna VANSTECHELMAN 2, Lore VERHULST 2, Astrid MUSSCHOOT 2 and Ellen VANDAMME 3
1) Ghent University Hospital, Department of Human structure and repair, Department of Rehabilitation Sciences, Department of Urology, Ghent, BELGIUM - 2) Ghent University, Department of Rehabilitation Sciences, Ghent, BELGIUM - 3) Ghent University Hospital, Department of Urology, Ghent, BELGIUM
INTRODUCTION
Children with Developmental Coordination Disorder (DCD) often present with impaired toilet training, LUTS and functional bowel problems, but research examining a possible association is scarce.
MATERIAL AND METHODS
A cross-sectional case-control study was conducted in 2023-2024. Parents of 5-to-8-year-old children with clinically diagnosed DCD completed an online survey including two standardized and validated questionnaires e.g. the Vancouver Symptom Score for Dysfunctional Elimination Syndrome (VSSDES) and the DCD-Questionnaire (DCDQ), and a non-validated questionnaire on toilet training. The control group consisted of parents of typically developing children (TDC) matched for sex and school grade.
RESULTS
Analysis included 42 children with DCD and 42 matched TDC. Children with DCD faced significantly more toilet training difficulties (p < 0.001). Difficulties with dressing and undressing were only present in the DCD group. Children with DCD demonstrated significantly more fecal incontinence at the age of four (24 % vs. 2.5 %; p = 0.004), more daytime urinary incontinence at the age of five (26 % vs. 7 %; p = 0.02) and more enuresis at the age of five (50 % vs. 26 %; p = 0.02). Children with DCD scored significantly worse on the VSSDES (Mean total score 11 vs. 7; p < 0.001). Lower scores on the DCD-Q were associated with worse VSSDES (r= -0.474, p<0.001).
CONCLUSION
Children with DCD face more challenges with toilet training, LUTS and functional bowel problems than TDC. Increased awareness with clinicians and within future research is necessary.
16:06 - 16:12
SN02-7 (OP)
Anka NIEUWHOF-LEPPINK 1, Emma WIERTZ 2, Silje VAN DEN BERG 2, Su VAN DER HEIDEN 2 and Keetje DE MOOIJ 3
1) Wilhelmina's Children Hospital, University Medical Center Utrecht, Urotherapy, Psychology & Pediatric Urology, Utrecht, NETHERLANDS - 2) Faculty of Social and Behavioral Sciences Utrecht University, MASTER PROGRAM: YOUTH DEVELOPMENT AND SOCIAL CHANGE, Utrecht, NETHERLANDS - 3) Wilhelmina's Children Hospital, University Medical Center Utrecht, Pediatric Urology, Utrecht, NETHERLANDS
PURPOSE
Urinary incontinence (UI) affects 3–4% of adolescents, negatively impacting mental health and quality of life. The stigma surrounding UI often leads to social isolation and concealment. This study aims to explore strategies to reduce stigma, promote mental well-being, and enhance social inclusion for adolescents with UI.
MATERIAL AND METHODS
A semi-structured interview guide was developed to facilitate in-depth discussions with professionals and adolescents recruited from a urotherapy patient group. The guide ensured comprehensive exploration of key issues. Data were analysed using narrative synthesis and open coding, with particular attention to ethical considerations and respect for participants' privacy, including obtaining informed consent.
RESULTS
Eleven semi-structured interviews were conducted with 5 professionals and 6 adolescents (4 girls and 2 boys) aged 14-17 years (M = 15.3). The findings highlighted the significant stigma associated with UI, resulting in secrecy, social isolation and emotional distress. As one participant noted, "I always say it's a bladder problem so it sounds less embarrassing", while another shared, "I call it leaking or dripping; it sounds less stupid". These quotes illustrate the complex interplay of visible and hidden stigma in their lives.
Interestingly, the findings on reducing stigma show a difference between professionals and adolescents. Both groups recognised the importance of awareness and understanding. However, professionals emphasised systemic changes, whereas adolescents emphasised personal trust and privacy as key factors.
CONCLUSIONS
The study highlights the complex relationship between UI, stigma, and adolescent mental health. Effective interventions for UI should raise awareness, promote openness, and involve key stakeholders.
One potential solution is the development of an anonymous online platform to support adolescents, reduce stigma, and enhance mental well-being by facilitating shared experiences and access to resources.
16:12 - 16:18
SN02-8 (OP)
Bieke SAMIJN 1, Mathilde JOOS 2, Christine VAN DEN BROECK 2, Hanna DE VIS 2, Loïc D'HAENE 2, Marieke CROONENBERGHS 2 and Ellen VANDAMME 3
1) Ghent University Hospital, Department of Human structure and repair, Department of Rehabilitation Sciences, Department of Urology, Ghent, BELGIUM - 2) Ghent University, Department of Rehabilitation Sciences, Ghent, BELGIUM - 3) Ghent University Hospital, Department of Urology, Ghent, BELGIUM
PURPOSE
Schools and teachers play a significant role in the lives of children and can have a substantial impact on their lower urinary tract (LUT) health. This study investigates the impact of lower urinary tract symptoms (LUTS) on school functioning and scholastic factors and perceptions associated with LUTS.
MATERIAL AND METHODS
A cross-sectional cohort study with triadic evaluation was conducted in twelve regular elementary schools in 2022-2024. Children completed the validated Dutch School-wellbeing questionnaire, parents the validated Dutch Vancouver Symptom Score for Dysfunctional Elimination Syndrome concerning their child and teachers a non-validated questionnaire based on the LUT health criteria from Ko et al. (2016)
RESULTS
171 children, 365 parents and 75 teachers filled in the questionnaires. Prevalence of LUTS was 21.8 %. No significant association was found between LUTS and general school functioning. However, a trend value (p= 0.09) suggested lower social relationships scores in the LUTS group indicating more bullying and loneliness. Schools with minimal vandalism, bullying and other negative behaviour in toilets showed low prevalence rates for daytime urinary incontinence. Unfortunately, most schools did not meet good LUT health criteria. Over half of the teachers (64%) were never informed about LUTS although 58.7% wanted to be informed. Parents’ expectations differed from those of teachers concerning the teacher’s role in LUTS treatment and drinking policy at school.
CONCLUSIONS
Creating awareness among parents and teachers can help prevent, identify and treat LUTS, making education protocols on LUT health essential.