ICCS & ESPU-Nurses Meeting on Friday 5, September 2025, 12:50 - 13:15
12:50 - 12:56
ICCS-S04-1 (OP)
Sofie AXELGAARD 1, Konstantinos KAMPERIS 2, Søren HAGSTRØM 3 and Luise BORCH 1
1) Gødstrup Hospital, Department of Pediatrics and Adolescent Medicine, Herning, DENMARK - 2) Aarhus University Hospital, Department of Pediatrics and Adolescent Medicine, Aarhus N, DENMARK - 3) Aalborg University Hospital, Department of Pediatrics and Adolescent Medicine, Aalborg, DENMARK
PURPOSE
Bladder and bowel dysfunction (BBD) affects up to 20% of children. Current guidelines recommend treating constipation before urinary incontinence, based on limited evidence.
This study aims to assess the effectiveness of constipation treatment in reducing daytime urinary incontinence, and to compare the outcomes of combining constipation treatment with urotherapy versus constipation treatment alone.
MATERIAL AND METHODS
Children aged 5-14 years (n=100) with treatment-naive BBD were randomized to receive either constipation treatment (n=50), or combination treatment with urotherapy (n=50) for 12 weeks. The primary outcome was reduction in the number of wet days per week.
RESULTS
To date, 54 children have completed the study. The median age in the constipation group was 7.0 years (IQR 6.0-8.0), and 6.6 years (IQR 5.0-9.0) in the combination group. Both groups consisted of 63% male participants. Median wet days per week decreased from 6.0 (IQR 4.0-7.0) to 3.5 (IQR 2.0-5.0) in the constipation group, and from 6.0 (IQR 3.0-7.0) to 3.0 (IQR 2.0-6.0) in the combination group. At follow-up, 15.4% in both groups had complete resolution (100% reduction) of urinary incontinence. Additionally, 48.2% in the constipation group, and 42.3% in the combination group had at least a 50% reduction in symptoms. No significant difference was observed between the groups (p = 0.170).
CONCLUSIONS
Constipation treatment alone effectively reduces daytime urinary incontinence in children with BBD. Both treatment strategies showed similar reductions in wet days per week, suggesting constipation treatment alone may be a sufficient first-line approach.
12:56 - 13:02
ICCS-S04-2 (OP)
Anderson LUIZ PIMENTEL FERREIRA 1, Felipe SANTOS MARIMPIETRI 2, Antonio Vitor NASCIMENTO MARTINELLI BRAGA 2, Taynna COSTA 2, Maria LUIZA VEIGA 1, Ana Aparecida NASCIMENTO MARTINELLI BRAGA 1, Glicia ESTEVAM DE ABREU 1 and Ubirajara BARROSO 3
1) Escola Bahiana de Medicina e Saúde Pública, Salvador, BRAZIL - 2) Salvador, BRAZIL - 3) Escola Bahiana de Medicina e Saúde Pública and Hospital Universitário Professor Edgar Santos, Salvador, BRAZIL
PURPOSE
Constipation accounts for 30% of gastro referrals, with 95% being functional constipation (FC). The bristol stool form scale (BSFS) classifies stools into seven types, associating types 1-2 with FC and 5-7 with FI. Its pediatric reliability, however, requires further validation. Therefore, we evaluated the accuracy of the BSFS in the diagnostic evaluation of FC.
MATERIAL AND METHODS
A retrospective cohort study (July 2021–December 2023) included first consultations of children with LUTS. Patients were divided into two BSFS-based groups using two criteria: Criterion 1, Group 1 (types 1, 2, 5, 6, 7), Group 2 (types 3, 4); Criterion 2, Group 1 (types 1, 2), Group 2 (types 3–7). Patients with incomplete data were excluded. FC diagnosis was defined by ≥2 positive Rome IV criteria. Statistical analysis included Chi-square tests for BSFS-FC associations and ROC curve (AUC) analysis for discriminatory/predictive capacity.
RESULTS
The sample included 244 children (median age 9 years; IQR 7–11), 124 (50.8%) were male. FC was diagnosed in 187 (76.7%) by Rome IV criteria, while 57 did not meet criteria. No significant heterogeneity was found in baseline characteristics between criteria. No association was observed between bristol stool form scale groups and FC diagnosis (p=0.460; p=0.260). BSFS discriminatory capacity, evaluated by AUC, was 0.542 (p=0.243), showing poor discrimination. Mean constipation scoring system scores were similar between groups: 10.45 (Group 1) vs. 10.41 (Group 2) in the second criterion.
CONCLUSIONS
The bristol stool form scale demonstrates low reliability in supporting the clinical diagnosis of functional constipation.
13:02 - 13:08
ICCS-S04-3 (OP)
Malin BORGSTRÖM 1, Barbro H SKOGMAN 2 and Tryggve NEVÉUS 1
1) Uppsala University, Department of Women's and Children's Health, Uppsala, SWEDEN - 2) Faculty of Medicine and Health, Örebro University, Örebro, SWEDEN
PURPOSE
The bowel's influence on enuresis is probably important even though debulking treatment by itself will not make the child dry. Parents and patients may be unaware of the child's constipation until the enuresis is evaluated. A crucial question is how common constipation is among children without bladder problems.
MATERIAL AND METHODS
In this prospective study we compared bladder and bowel function in children with enuresis and controls without any bladder-related problems. The former group was recruited from a pediatric clinic and the latter from the general public. All children registered bowel movements during two weeks and bladder function during two days.
RESULTS
We recruited 66 children with enuresis and 58 controls. The ages ranged from 6 to 11 (mean 7.3 ± 1.3) years and 50 of them were girls. The groups had similar risk to be constipated according to the Rome IV criteria. The patients had slightly fewer bowel movements per two weeks (11.4 ± 4.0 vs 14.4 ± 5.8, P=0.001) but otherwise no more signs of constipation than the controls. But the bladder diaries showed that the enuretic children had smaller voided volumes (87.1 ± 31.8 vs 122.7 ± 37.7 % of expected bladder capacity; p <0.001).
CONCLUSIONS
We did not find support for constipation being more common among children with enuresis. But we did find indirect support for detrusor overactivity.
13:08 - 13:14
ICCS-S04-4 (OP)
Malin BORGSTRÖM 1, Barbro H SKOGMAN 2 and Tryggve NEVÉUS 3
1) Uppsala University, Department of Women's and Children's Health, Uppsala, SWEDEN - 2) Örebro University, Faculty of Medicine and Health, Örebro, SWEDEN - 3) Uppsala University, Uppsala, Department of Women's and Children's Health, Uppsala, SWEDEN
PURPOSE
There is a well-known link between constipation and bladder dysfunction, especially in children with voiding dysfunction, daytime incontinence or recurrent urinary tract infections. The link is less clear for enuresis, as are the urodynamic consequences of constipation. We wanted to test, whether constipation influenced bladder function.
MATERIAL AND METHODS
In this prospective study we compared bladder and bowel function in children with enuresis and controls. We have previously reported that constipation was equally common in both groups. All children registered bowel movements during two weeks, bladder function during two days and underwent uroflow measurements. Data were compared between subjects with and without constipation according to Rome IV criteria.
RESULTS
We recruited 124 children, aged 6-11 years (50 girls), 43 of whom were found to be constipated. Their voiding chart data were similar; i e. average and maximal voided volumes (expressed as percentages of expected bladder capacity) did not differ (average 52.7 ± 18.7 vs 51.2 ± 21.8, p = 0.704; maximum 88.2 ± 35.0 vs 84.8 ± 32.6, p = 0.608). No child had a pathological uroflow or residual urine.
CONCLUSIONS
Even though we already know that constipation and bladder dysfunction are related, we failed to find this reflected in noninvasive urodynamic parameters. This lack of urodynamic abnormalities may be an indicator that the link between the bowel and the bladder is more about central nervous mechanisms than anatomy or peripheral bladder function.