ICCS & ESPU-Nurses Meeting on Thursday 4, September 2025, 17:25 - 17:55
17:25 - 17:31
SN08-1 (OP)
Melis ÜNAL, Ece Zeynep SAATÇI, Tuğçe OSKAY, Tuğba KURT and Dilara Damla KALIN
Uropelvic Solutions Pelvic Floor Rehabilitation Center, Pediatric Urology, İstanbul, TÜRKIYE
PURPOSE
Various treatments, such as enuresis alarms,desmopressin,and anticholinergic drugs, exist,but some children may be resistant to therapy.This retrospective study aimed to compare pelvic floor muscle rehabilitation(PFMR) outcomes between children receiving enuresis treatment for the first time and those previously unresponsive to treatments, classified as treatment-resistant.
MATERIAL AND METHODS
The study included 82 children: 42 in the control-group(first enuresis treatment) and 40 in the resistant-group(previously treated with desmopressing, anticholinergic or enuresis alarms but unresponsive).PFMR involved urotherapy,biofeedback,breathing and core exercises, enuresis alarm,and manual therapy, and was terminated upon complete response per ICCS criteria.Enuresis frequency was tracked using a diary, and symptoms were evaluated with the Dysfunctional Voiding and Incontinence Scoring System(DVISS).Pre- and post-PFMR comparisons were made between groups.Additionally, the number of PFMR sessions and the response week to the alarm were compared.
RESULTS
Enuresis frequencies and DVISS were similar before PFMR but significantly higher in the resistant-group after PFMR.The resistant-group also had more PFMR sessions,with no significant difference in alarm response weeks(Table 1).
|
Parameters |
Control-Group |
Resistant-Group |
p |
|
Enuresis Frequency Pre-PFMR(day/weeks) |
6.33±1.22 |
6.63±0.95 |
0.166 |
|
Enuresis Frequency Post-PFMR(day/weeks) |
0.14±0.42 |
1.13±2.14 |
0.014* |
|
DVISS Pre-PFMR |
13.36±4.36 |
13.58±5.68 |
0.741 |
|
DVISS Post-PFMR |
0.21±0.68 |
1.03±1.98 |
0.016* |
|
PFMR sessions(n) |
8.93±3.72 |
10.78±3.51 |
0.023* |
|
Alarm response weeks (n) |
1.62±1.04 |
2.83±3 |
0.116 |
Daha expressed Mean ± Standard Deviation,Mann Whitney U Test,*p<0.05
CONCLUSIONS
PFMR improved enuresis frequency and DVISS in both groups.However, the treatment-resistant group demonstrated higher post-treatment DVISS and required a greater number of PFMR sessions.No significant difference was found in alarm response weeks.These findings suggest that while PFMR may be an effective approach for both children receiving enuresis treatment for the first time and those who are treatment-resistant,the resistant group may require a longer treatment duration to achieve optimal outcomes.
17:31 - 17:37
SN08-2 (OP)
Ece Zeynep SAATÇI 1, Halil TUGTEPE 2, Elif Elçin DERELI 3, Wendy BOWER 4 and Tuğba KURU ÇOLAK 5
1) Uropelvic Solutions Pelvic Floor Rehabilitation Center, Pediatric Urology, Ataşehi̇r, TÜRKIYE - 2) Tugtepe Pediatric Urology Clinic, Istanbul, TÜRKIYE - 3) İstanbul Bilgi University, Division of Physiotherapy and Rehabilitation, İstanbul, TÜRKIYE - 4) Melbourne University, Medicine, Dentistry and Health Sciences, Parkville, AUSTRALIA - 5) Marmara University, Division of Physiotherapy and Rehabilitation, İstanbul, TÜRKIYE
PURPOSE
The aim of this study is to culturally adapt the Turkish version of the Pin-Q, a quality of life scale specific to urinary incontinence in children with LUTD, and to evaluate its validity and reliability. Additionally, the study examines the relationships between the Pin-Q and other validated scales, such as the Pediatric Quality of Life Inventory (PedsQL) and the Dysfunctional Voiding and Incontinence Scoring System (DVISS).
MATERIAL AND METHODS
Between December 2023 and March 2024, 120 children aged 5-12 years diagnosed with LUTD were included. The translation and cultural adaptation of the Pin-Q scale followed Beaton's (2000) methodology. The scale was translated by two independent translators, synthesized, and back-translated. A final Turkish version was developed after expert committee review and a pretest with 5 pediatric patients. The Pin-Q, PedsQL, and DVISS scales were applied, and internal consistency was assessed using Cronbach's alpha, while test-retest reliability was evaluated using the Intraclass Correlation Coefficient (ICC). Spearman correlation analyses were performed using the Spearman correlation coefficient, and all analyses were conducted using IBM SPSS version 23.
RESULTS
The mean age of the participants was 8.87 years, with a BMI of 16.67 kg/m². The Turkish version of the Pin-Q showed high internal consistency (Cronbach's alpha = 0.959). ICC values for test-retest reliability ranged from 0.787 to 0.983. Spearman correlation analyses revealed a significant relationship between the Pin-Q scores and both the PedsQL and DVISS (r=0.512, p<0.001 and r=0.466, p<0.001).
CONCLUSIONS
The Turkish version of the Pin-Q was found to be a valid and reliable tool, demonstrating high internal consistency and moderate correlation with other validated scales (PedsQL and DVISS). These findings support the use of the Pin-Q scale in the Turkish pediatric population.
17:37 - 17:43
SN08-3 (OP)
Yagmur TURHAN 1, Ece Zeynep SAATCI 2, Melis UNAL 2, Yasar ISSI 1, Halil TUGTEPE 2 and Ali AVANOGLU 1
1) Avanoglu-Issı Pediatric Urology Clinic, Pediatric Urology, Izmir, TÜRKIYE - 2) Uropelvic Solutions Pelvic Floor Rehabilitation Center, Pediatric Urology, Istanbul, TÜRKIYE
PURPOSE
Hinman Syndrome (HS) is a rare condition involving dysfunctional voiding and renal injury, mimicking neuropathic bladder dysfunction. Symptoms often include daytime urinary incontinence (DUI), nocturnal incontinence (NI), constipation, fecal incontinence (FI) and post-voiding residue (PVR), as part of the lower urinary tract symptomatology.
This study aimed to evaluate the efficacy of pelvic floor muscle rehabilitation (PFMR) on these symptoms in pediatric patients with HS.
MATERIAL AND METHODS
This study evaluated the efficacy of pelvic floor muscle rehabilitation (PFMR) in six pediatric patients (4 girls, 2 boys) with HS, aged 6 to 14 years (mean: 12.3 years).
Physiotherapists administered weekly 75-minute PFMR sessions, averaging 15 per patient, supplemented with home exercises. The PFMR protocol included urotherapy, diaphragmatic breathing, core stabilization exercises, manual therapy and biofeedback. Pre- and post-treatment assessments involved pelvic floor muscle evaluation using the Modified Oxford scale, uroflowmetry and EMG-based activation assessment. Symptoms were monitored using the Dysfunctional Voiding and Incontinence Symptom Score (DVISS), PVR volume measurements and the frequency of FI, DUI, and NI episodes documented in 7-day bowel and 2-day bladder diaries.
RESULTS
Pre- and post-treatment data are provided below.
|
|
Pre-Treatment |
Post-Treatment |
|
Symptoms |
|
|
|
Constipation,(n) |
6 (100%) |
0 (0%) |
|
FI,(n) |
3 (50%) |
0 (0%) |
|
DUI,(n) |
5 (83,3%) |
0 (0%) |
|
NI,(n) |
4 (66,6%) |
2 (33,3%) |
|
DVISS,points |
16.5 |
3.6 |
|
Uroflowmeter Parameters |
|
|
|
Voiding Volume(ml) |
234.65 |
301.58 |
|
Maximum Flow Rate(Qmax, ml/s) |
27.93 |
25.35 |
|
Micturition Time(sec) |
74.16 |
24.16 |
|
PVR(ml) |
115.3 |
17 |
CONCLUSIONS
The results demonstrated significant symptom reduction and improved quality of life in children with HS. Further studies with larger sample sizes are necessary to confirm these findings and explore the long-term efficacy of PFMR in managing HS.
17:43 - 17:49
SN08-4 (OP)
Rabi̇a AŞIK 1, Asli ÖZTÜRK 2, Cem IRKILATA 3, Canan SEYHAN 2, Gi̇ray ERGİN 4 and Musa Murat DAYANÇ 2
1) DAYANC UROLOGY CENTER, PEDIATRIC UROLOGY, Ankara, TÜRKIYE - 2) PRIVATE DAYANC PEDIATRIC UROLOGY CENTER, PEDIATRIC UROLOGY, Ankara, TÜRKIYE - 3) LOKMAN HEKIM ISTANBUL HOSPITAL, PEDIATRIC UROLOGY, İstanbul, TÜRKIYE - 4) PRIVATE KORU HOSPITAL, UROLOGY, Ankara, TÜRKIYE
PURPOSE
Nocturnal detrusor overactivity(NDO) is one of the factors playing a role in the pathophysiology of monosymptomatic nocturnal enuresis(MNE).The Nocturnal Bladder Capacity Index (NBCi) evaluates nocturnal bladder capacity and the number of episodes together and predicts NDO.We aimed to use NBCi to adjust treatment accordingly in children with MNE and to determine the outcomes of follow-up treatment.
MATERIAL AND METHODS
A total of 41 children with MNE, mean age of 8,4±2,73, were included in the study.Before treatment, patients' voiding diary (maximum volume voided, frequency of urination), nocturnal bladder capacity, and number of enuretic episodes were determined.The NBCi was calculated using the formula: NBCi = Fn-(Vn/Vmax-1).
Patients were treated individually with standard urotherapy, alarm treatment, and pelvic floor muscle rehabilitation.Antimuscarinic therapy was added to the treatment of patients who did not respond to combined treatment and had a high NCBI score.Changes in alarm frequency and NBCi were followed up by taking weekly average values.
RESULTS
After 1 month treatment, alarm frequency decreased from 5,82±0,57 to 2,06±0,28, NCBi decreased from 0,843±0,37 to 0,468±0,17(p =0,0001 and 0,0001, respectively) (Table).
Of the 4 children who did not respond to classical treatment, 3 with high NCBi values (mean 1,17) responded to antimucarinic treatment, while 1 with low NCBi value (0,57) did not respond.
Table: Weekly alarm frequency and NCBi value with classical combined treatment of children with MNE
|
|
Week 1 |
Week 2 |
Week 3 |
Week 4 |
P value |
|
Alarm Frequency |
5,82±0,57 |
4,18±,0,46 |
3,09±0,4 |
2,06±0,28 |
0,0001 |
|
NBCi |
0,843±0,37 |
0,679±0,34 |
0,567±0,22 |
0,468±0,17 |
0,0001 |
CONCLUSIONS
During MNE treatment, it is observed that the NBCi value decreases as the number of alarms ringing decreases. In the success of MNE treatment, improvement of nocturnal bladder dynamics is important in addition to dryness.In children who do not respond to conventional treatment, high NCBi levels should suggest initiating antimuscarinic therapy.
17:49 - 17:55
SN08-5 (OP)
Canan SEYHAN 1, Asli OZTURK 1, Rabia AŞIK 1, Hasan Cem IRKILATA 2 and Murat DAYANÇ 1
1) Private Dayanc Pediatric Urology Center, Ankara, TÜRKIYE - 2) Lokman Hekim İstanbul Hospital, İstanbul, TÜRKIYE
PURPOSE
This study aimed to evaluate the effectiveness of combined standard urotherapy, alarm therapy and pelvic floor muscle rehabilitation(PFMR) in children with monosymptomatic nocturnal enuresis(MNE).
MATERIAL AND METHODS
A total of 65 children(17 girls/48 boys), mean age 9,2 (Range 5 to 18), diagnosed as MNE participated in this study.Children were evaluated noninvasively to distinc from other conditions and the pelvic floor muscle(PFM) assessment measured before and after treatment.All children managed by combined therapy and PFMR for 3 months.Each time the alarm activated, the following data were recorded by the parents:the number of alarm activations during night(NAADN),the amount of urine absorbed by the diaper(AUAD),and the amount of urine voided into the measuring cup immidiately after bedwetting(AUVCAB).
RESULTS
The average number of sessions was 9,3(range 3 to 25).A total of 49(75,4%) of children were completely dry and 16(24,6%) were improved at the end of the management.NAADN was reduced significantly in time(Table).AUAD reduced and AUVCAB increased significantly in time(Table).The relaxation, contraction, and functional contraction amplitudes(FCA) of the PFM showed significant improvement after treatment(for all p=0,0001)(Table).
|
Mean±SD |
1st month,weekly |
1st month,total (n=61) |
2nd month,total (n=32) |
3rd month,total (n=16) |
p values |
|||||
|
|
1st week |
2nd week |
3rd week |
4th week |
|
|
|
|
||
|
NAADN,number |
3,8±3,2 |
2,3±2,5 |
1,8±2,2 |
1,0±1,2 |
9,0±7,8 |
1,9±2,9 |
0,5±1,2 |
0,0001 |
||
|
AUAD,gr |
65,7±6,8 |
20,9±5,4 |
3,7±1,4 |
0,0001 |
||||||
|
AUVCAB,ml |
135,3±72,6 |
138,1±46,2 |
163,5±54,38 |
0,0001 |
||||||
|
PFMA,µV |
Before treatment |
After treatment |
0,0001 0,0001 0,0001 |
|||||||
|
Contraction |
Relaxation |
FCA |
Contraction |
Relaxation |
FCA |
|||||
|
4,14±2,38 |
2,53±1,04 |
1,60±2,04 |
8,5±2,9 |
1,36±0,38 |
7,07±3,03 |
|||||
CONCLUSIONS
The study demonstrates that a combined approach significantly improves nocturnal enuresis and pelvic floor muscle function in children with MNE.