ICCS & ESPU-Nurses Meeting on Wednesday 3, September 2025, 16:30 - 17:06
16:30 - 16:36
SN03-1 (OP)
Aygul KOSEOGLU KURT 1, Abdullah Harun KINIK 2 and Mesrur Selcuk SILAY 3
1) Pelvic Urology Center, Pelvic Floor Rehabilitation, Istanbul, TÜRKIYE - 2) Gaziosmanpasa Research and Training Hospital, Urology Department, Istanbul, TÜRKIYE - 3) Medipol University, Pediatric Urology Department, Istanbul, TÜRKIYE
PURPOSE
ChatGPT is an AI and natural language processing technology that supports health decision-making, enhances healthcare quality, and expands accessibility. It also optimizes health system efficiency while offering significant opportunities for clinical decision support and patient education. Our study aims to evaluate the usability of ChatGPT in urotherapy for children with lower urinary tract dysfunction (LUTD) by assessing its recommendations' quality and alignment with EAU/ESPU and ICCS guidelines.
MATERIAL AND METHODS
A total of 28 core items on urotherapy education for children with LUTD were presented to ChatGPT in question format and evaluated independently by a pediatric urologist (5 years of experiences) and a pelvic floor physiotherapist (8 years of experiences) using the Global Quality Score (GQS) system. Blinding was applied, and discrepancies in scores were resolved through re-evaluation and consensus; if consensus was not reached, a third pediatric urologist (21 years of experiences and guideline panel member) made the final decision.
RESULTS
According to the GQS scale, scores of 1-2 indicate "poor quality," 3 indicate "average quality," and 4-5 indicate "high-quality responses." No responses received a score of 1 or 2, so only 3, 4, and 5 scores were included in the analysis. Among the responses, 64.29% (n=18) received a score of 5, 25.00% (n=7) received a score of 4, and 10.71% (n=3) received a score of 3. Responses classified as having average quality comprised 10.71% of the total, while high-quality responses accounted for 89.29%. The mean score for all responses was 4.54.
CONCLUSIONS
These results suggest that ChatGPT has significant potential as a tool for supporting urotherapy for children with LUTD.
16:36 - 16:42
SN03-2 (OP)
Rabi̇a AŞIK 1, Canan SEYHAN 1, Cem IRKILATA 2, Asli ÖZTÜRK 1, Burak KÖPRÜ 3 and Musa Murat DAYANÇ 1
1) PRIVATE DAYANC PEDIATRIC UROLOGY CENTER, PEDIATRIC UROLOGY, Ankara, TÜRKIYE - 2) LOKMAN HEKIM HOSPITAL, PEDIATRIC UROLOGY, İstanbul, TÜRKIYE - 3) PRIVATE KORU HOSPITAL, UROLOGY, Ankara, TÜRKIYE
PURPOSE
Overactive bladder(OAB) is the most common subtype of lower urinary tract dysfunction(LUTD) in children.The OAB Index(OABI) is calculated using uroflowmetry parameters and provides diagnosis with 97% accuracy.Flow index(FI) is an index that objectively provides the distinction of continuous voiding patterns.We examined the changes in OABI and FI after treatment in children with OAB.
MATERIAL AND METHODS
Sixty-six patients diagnosed as OAB after non-invasive evaluation were included the study.Patients were treated in an individualized manner with standard urotherapy, antimuscarinics, and pelvic floor muscle rehabilitation.To calculate OABI, three uroflowmetry parameters were used:Uroflowmetry index(UI=Qave/Qmax), voided volume rate(VVR=voided volume/expected bladder capacity) and time to Qmax(TQmax).
OABI=8(UI)+9(VVR)+0,5(TQmax) calculated with this formula.In calculating the FI,firstly the expected Qmax value(Qmax-est) according to the total bladder capacity(TBC) was calculated with the formula:“Qmax-est=11.26+0.0701*TBC-0.0000513*TBC*TBC”.Then the FI was calculated by dividing the actual Qmax value by Qmax-est.
RESULTS
The mean±sd values of OABI and FI before and after treatment shown in the table. The mean±sd value of OABI of all patients increased from 8.66±1.48 to 10.74±2.71(p=0,0001). FI values decreased in the tower pattern and increased in the plateau pattern, and the other word normalized both(p=0,0001 and p=0,028, respectively).
|
Voiding Pattern
|
OABI |
FI |
||||
|
Before Treatment |
After Treatment |
P value |
Before Treatment |
After Treatment |
P value |
|
|
Tower,(n=25) |
7,79 ± 1,21 |
10,13±2,59 |
0,0001 |
1,495 ± 0,35 |
1,136 ±0,25 |
0,0001 |
|
Bell,(n=34) |
9,12 ± 1,34 |
11,39 ±2,82 |
0,0001 |
0,920 ± 0,13 |
0,864 ±0,14 |
0,149 |
|
Plateau,(n=7) |
9,49 ± 1,63 |
9,75 ±1,89 |
0,028 |
0,601 ± 0,08 |
0,819 ± 0,18 |
0,028 |
Table 1: Changes of overactive bladder index(OABI) and flow index(FI) according to voiding patterns in children with overactive bladder after treatment
CONCLUSIONS
The OABI increases and the FI normalizes in children with OAB, after treatment. Treatment success can be evaluated with symptom scores and indexes based on uroflowmetry.
16:42 - 16:48
SN03-3 (OP)
Nao IGUCHI 1, Anna MALYKHINA 1 and Duncan WILCOX 2
1) University of Colorado School of Medicine, Surgery, Aurora, USA - 2) Children's Hospital Colorado, Pediatric Urology, Aurora, USA
PURPOSE
This study aimed to investigate the pathological mechanisms behind bladder and bowel dysfunction (BBD), a common yet often underdiagnosed pediatric condition marked by lower urinary tract symptoms (LUTS) and abnormal bowel habits like constipation and/or encopresis. BBD is known to cause long-term complications such as recurrent UTIs, vesicoureteral reflux, and renal scarring, but the mechanisms behind these links remain unclear. We hypothesize that bowel dysfunction induces bladder-bowel cross-organ sensitization via overlapping neural pathways and tissue changes, including inflammation, fibrosis, and alterations in cellular signaling and connectivity.
MATERIAL AND METHODS
With IACUC approval, functional constipation was induced in juvenile male mice by surgically narrowing the external anal sphincter. Sham-operated mice served as controls. Four days post-surgery, the effects of constipation were evaluated using in vivo urodynamic studies and in vitro physiological assessments of bladder strips. Additionally, quantitative RT-PCR was used to analyze gene expression patterns in the bladder and lumbosacral dorsal root ganglia (LsDRG).
RESULTS
Constipation caused detrusor overactivity, shown by increased urinary frequency and spontaneous contractions. Gene expression analysis revealed a 1.5-fold upregulation of excitatory serotonin receptors (Htr2a, Htr2c) in the bladder (p<0.05). Serotonin enhanced spontaneous activity in bladder strips from constipated mice, increasing frequency and force by 1.6- and 2.4-fold, respectively (p<0.0001). These effects were reversed by ketanserin, an Htr2 antagonist. Additionally, the LsDRG in constipated mice showed a 1.6- to 1.8-fold increase in genes modulating sensory activation, including serotonin receptors (Htr1a, Htr3) and Mrgprb2 (p<0.05).
CONCLUSIONS
The findings highlight how constipation alters sensory pathways, contributing to detrusor overactivity and increased bladder activity. Upregulation of serotonin receptors and sensory modulators plays a key role in bladder dysfunction, suggesting these receptors as potential therapeutic targets for children with BBD.
16:48 - 16:54
SN03-4 (OP)
Lola BLADT 1, An BAEL 2, Nathalie SEGERS 2, Karolien DE MOERLOOSE 3, Katrien KLOCKAERTS 4, Hendrik-Jan FLORIN 5, Lukas VAN CAMPENHOUT 1, Alexandra VERMANDEL 6, Karen DE BAETS 6 and Gunter DE WIN 6
1) University of Antwerp, Product Development, Antwerp, BELGIUM - 2) ZAS Queen Paola Children Hospital, Pediatrics, Antwerp, BELGIUM - 3) General Hospital Voorkempen, Pediatrics, Malle, BELGIUM - 4) Private Practice, Urology, Aalst, BELGIUM - 5) Imelda Hospital, Urology, Bonheiden, BELGIUM - 6) University Hospital Antwerp, Urology, Edegem, BELGIUM
PURPOSE
Bladder diaries are essential for diagnosing pediatric urinary incontinence, but compliance with paper diaries is low. Electronic alternatives eliminate paper but still depend on manual measurement and entry of voided volumes. This study validates an automated diary using the Minze Diary Pod, which automatically records and sends voided volumes to a smartphone app.
MATERIAL AND METHODS
This multi-center randomized crossover study compared automated and paper bladder diaries in terms of agreement, compliance, and patient satisfaction. Patients completed both formats in a random order, each for at least two consecutive days, with a washout period of 2 to 6 days. The comparison was based on Bland-Altman analysis, patient surveys, and clinicians’ evaluations.
RESULTS
The study included 63 patients (M:39, F:24; mean age 7.2y, SD 1.9y, range 3–13y). The Bland-Altman analysis revealed no systematic bias between the methods. However, it showed moderate to wide limits of agreement, reflecting variability likely due to natural fluctuations and differences in measurement methods, including the high variety of measuring jugs observed with the paper diary. Clinically, the relevance of this variability was mixed. When clinicians were asked to choose a preferred diary for diagnostic purposes among patients completing both (n=39), 36% chose automated, 28% paper, and 36% had no preference. Patients strongly favored the automated diary: 78% of children and 89% of parents preferred it (n=37). 74% found it pleasant to use (vs. 28% for paper), all parents reported child participation (vs. 78% for paper), and only 10% found it prone to mistakes (vs. 20% for paper).
CONCLUSIONS
Both methods are clinically useful, but the automated diary’s higher user preference may better support compliance. While differences may not be clinically significant for one-time assessments, a standardized approach may be crucial for tracking progress and ensuring reliable comparisons.
16:54 - 17:00
SN03-5 (OP)
Canan SEYHAN 1, Rabia AŞIK 1, Aslı ÖZTÜRK 1, Hasan Cem IRKILATA 2 and Murat DAYANÇ 1
1) Private Dayanc Pediatric Urology Center, Ankara, TÜRKIYE - 2) Lokman Hekim İstanbul Hospital, Istanbul, TÜRKIYE
PURPOSE
This study presents an initial case series on the use of standard urotherapy and PFMR to manage EDOUF and GI in children.
MATERIAL AND METHODS
Six children with EDOUF and six with GI participated in the study.Children were evaluated with the Dysfunctional Voiding and Incontinence Symptom Score (DVISS).Each child attended a 75-minutes standard urotherapy education session and followed by individualized PFMR sessions. The rehabilitation program included manual therapy, diaphragmatic breathing, core exercises, PFM training with surface EMG biofeedback.
RESULTS
The work average increased from 5.8 µV to 14 µV, while relaxation decreased from 2.6 µV to 1.8 µV for GI. Symptom scores improved, dropping from 11.5 to 1.1. For EDOUF, the work average increased from 2.4 µV to 7.8 µV, while the rest average decreased from 2.1 µV to 1.3 µV. Additionally, daytime toilet visits decreased from 26.1 to 8, and symptom scores dropped from 9.8 to 0.8.
|
|
DVISS-BT |
Rest Average-BT |
Work Average-BT |
Session |
DVISS-AT |
Rest Average-AT |
Work Average-AT |
|
|
GI,n=6 |
1 |
10 |
5 |
8 |
8 |
0 |
2,8 |
12 |
|
2 |
9 |
1,5 |
7 |
8 |
1 |
0,5 |
11 |
|
|
3 |
13 |
2,6 |
6,8 |
9 |
1 |
1,5 |
9 |
|
|
4 |
18 |
3,5 |
3,5 |
18 |
1 |
2 |
13 |
|
|
5 |
15 |
1,5 |
6 |
12 |
2 |
2,7 |
36 |
|
|
6 |
13 |
2 |
4 |
15 |
2 |
1,5 |
7 |
|
|
EDOUF,n=6 |
1 |
8 |
1,5 |
1,5 |
5 |
1 |
1,5 |
5 |
|
2 |
10 |
1,6 |
1,6 |
4 |
0 |
1,2 |
10 |
|
|
3 |
8 |
1,7 |
1,7 |
5 |
1 |
1,1 |
8 |
|
|
4 |
8 |
3,5 |
3,5 |
3 |
1 |
1,5 |
6 |
|
|
5 |
12 |
1,1 |
1,1 |
8 |
2 |
1 |
8 |
|
|
6 |
13 |
3,6 |
5 |
12 |
0 |
1,5 |
10 |
CONCLUSIONS
This study suggests that a nonpharmacological approach, combining standard urotherapy and PFMR is an effective treatment modality for managing EDOUF and GI in children.
17:00 - 17:06
SN03-6 (OP)
Markie CROFT, Sarah BOULBY, Louise KELLY, Cheryl ROWE, Hannah COMMANDER and Simona RUSU
Sheffield Children's Hospital NHS Foundation Trust, Pediatric Surgery Unit, Sheffield, UNITED KINGDOM
PURPOSE
The management of non-neuropathic voiding dysfunction still represents a challenge, with a vast number of children's lives impacted by this condition. Aiming to improve their life, we introduced the use of portable EMG-biofeedback machine.
MATERIAL AND METHODS
We prospectively kept a record of patients who used portable EMG-biofeedback between February 2023 and February 2024. Data collection included demographics, review of investigations and management, uroflowmetry pre-post usage of the machine at home, and documented symptomatology. All patients had teaching/demonstration sessions in the hospital and had the machine for 6 weeks at home. Full compliance was defined by daily usage.
RESULTS
We had recruited 45 patients who completed the 6-week course of portable EMG-feedback and had clinic follow-up afterwards (17 boys, 28 girls, median age 13 years, 7-18 years). The symptomatology was in 34/45 wetting accidents, 5/45 urinary tract infection symptoms like, 13/45 urgency and frequency. Six have a neurodiversity diagnosis. Compliance was maximum in 33/45 (73%) (all 6 neurodiverse children used it daily), 6/45 used it intermittently, and 6/45 did not use it. Complete improvement of symptoms was noted in 9/45 (20%) children, partially in 14/45 (31%) (having now a second course of treatment), and none in 22/45 (49%). The uroflowmetry parameters were improved in 26/45 (58%) children. Despite excellent compliance, none of the children with neurodiversity showed any improvement.
CONCLUSIONS
Portable EMG-feedback could be used as an alternative to the hospital/ outpatient method. While our initial results do not show a massive positive outcome, studies on a larger number of patients would be desirable. Targeted selection of the children should be considered, considering the negative results in the neurodiversity group despite adequate compliance.