ESPU-Nurses Meeting on Friday 19, June 2026, 09:30 - 10:10
09:30 - 09:40
SN07-1 (NP)
Eline VAN DE WETERING 1, Liesbeth DE WALL 2, Anka NIEUWHOF-LEPPINK 3, Wout FEITZ 2, Laetitia DE KORT 4 and Anke OERLEMANS 5
1) Amalia Children's Hospital, Radboudumc, Paediatric Urology, Nijmegen, NETHERLANDS - 2) Amalia Children's Hospital, Radboudumc, Pediatric Urology, Nijmegen, NETHERLANDS - 3) Wilhelmina Children's Hospital, University Medical Center Utrecht, Department of Medical Psychology and Social Work, Utrecht, NETHERLANDS - 4) University Medical Center Utrecht, Urology, Utrecht, NETHERLANDS - 5) Radboudumc, IQ Health Science Department, Nijmegen, NETHERLANDS
PURPOSE
Functional daytime urinary incontinence (DUI) is a prevalent condition in children, impacting their psychosocial well-being and often that of their parents. Urotherapy is recommended as first-line treatment modality and its efficacy depends on motivation and adherence. Wearable alarm tools are often used in urotherapy to help children recognize and respond to bladder signals, yet adherence varies widely. Research into the thoughts and experiences of children and their parents with the use of alarm tools in urotherapy is currently lacking. Gaining this insight will enable a more patient-adjusted approach, thereby potentially increasing adherence and treatment success.
MATERIAL AND METHODS
A qualitative study was conducted, comprising individual or dual, semi-structured interviews. Interviews were held with the child while the caregiver was present, or with the caregiver alone. In some cases, the caregivers spoke on behalf of their child. Eligible children with DUI were 6-15 years old who were currently receiving or had concluded urotherapy with a timer watch, alarm pants and/or bladder sensor. Interviews were conducted online via videocall, transcribed and analyzed using an inductive analysis approach until data saturation was reached.
RESULTS
Interviews were held with 11 mothers and 10 children. Practical barriers for adherence included tool size, malfunctions and connectivity issues with the device. Children expressed shame and fear of judgment regarding their condition and the alarm tool, indicating a preference for invisible tools and silent alerts. Inability to adequately interpret and respond to the sensation of a full bladder was reported by the majority, which impacted the utilization of the alarm tools and the expectations regarding their efficacy. Motivation and adherence were mentioned as key factors for treatment success and were influenced by the perceived tool efficacy and the feedback modality.
CONCLUSIONS
Experiences with alarm tools in urotherapy are influenced by psychosocial, sensory, motivational and practical aspects. According to our participants, the ideal alarm tool should be comfortable, discrete, provide real-time feedback on bladder fulness and increase awareness of bladder signals. A child-centered, personalized approach that integrates motivational support, discretion, and attention to sensing bladder signals may improve adherence and continence outcomes in children with DUI.
09:40 - 09:50
SN07-2 (NP)
Joana DOS SANTOS, Lisa WANG, Mandy RICKARD, Kay RIVERA, Adree KHONDKER, Abby VARGHESE, Rodrigo ROMAO, Joao Luiz PIPPI SALLE, Mirriam MIKHAIL, Beverly MIRANDA, Michael CHUA and Armando J. LORENZO
The Hospital for Sick Children, Urology, Toronto, CANADA
PURPOSE
Intra-detrusor BTA injections are a well-established intervention for refractory neurogenic bladder, but evidence for its value in pediatric non-neurogenic lower urinary tract dysfunction remains limited. We evaluated the clinical impact of BTA on continence, bladder emptying, and medication burden in children with refractory functional and anatomical non-neurogenic conditions.
MATERIAL AND METHODS
We reviewed 31 children treated with intra-detrusor and/or sphincteric BTA for dysfunctional voiding (DV), overactive bladder, posterior urethral valves/atresia, Hinman’s syndrome, giggle incontinence, pelvic pain syndrome, or iatrogenic dysfunction. Outcomes included continence response, post-void residuals (PVRs), and bladder medication use. Statistical comparisons were performed using Mann–Whitney U and Fisher’s exact tests.
RESULTS
Median age at first injection was 8.3 years (IQR 6.8-12.6). BTA was administered to the detrusor (61%), sphincter/bladder neck (36%), or both (3%). Overall continence improved in 85%, with 78% achieving complete resolution. Among detrusor-treated patients, 26% became fully dry with BTA alone. Fourteen patients (45%) required catheterization, most commonly those with PUV (23%). Catheter use was uncommon in children with OAB (3%) or dysfunctional voiding (6%). Patients with DV experienced a dramatic improvement in bladder emptying,with median PVR decreasing from 188 mL to 6.5 mL (p = 0.0012). Medication burden also significantly decreased: the proportion requiring no bladder medications increased from 0% to 25% (p=0.0047). Complications were minimal and limited to isolated UTIs (13%) and transient hematuria (3%).
|
Variable |
Overall (n=31) |
Key Findings |
|
CIC/SPT use |
14 (45%) |
— |
|
Primary diagnoses |
DV 10 (33%) |
— |
|
Age at first BTA |
8.3 yrs (IQR 6.8–12.6) |
— |
|
Number of BTA sessions |
4 (IQR 1–6) |
— |
|
Injection site |
Detrusor 61%, Sphincter 36%, Both 3% |
— |
|
Complications |
Febrile UTI 10%; Afebrile 3%; Hematuria 6% |
No major events |
|
Medication-free |
0% → 25% |
p = 0.0047 |
|
PVR (DV patients) |
188 → 6.5 mL |
p = 0.0012 |
CONCLUSIONS
BTA is a safe, effective, and potentially underutilized therapy for pediatric non-neurogenic bladder dysfunction. In well selected cases it achieves high continence rates, restores efficient bladder emptying—particularly in DV—and meaningfully reduces medication dependence. These findings support earlier adoption of BTA for refractory non-neurogenic lower urinary tract dysfunction.
09:50 - 10:00
SN07-3 (NP)
Eline VAN DE WETERING 1, Liesbeth DE WALL 2, Anka NIEUWHOF-LEPPINK 3, Marleen TROMPETTER 4, Eveline LEIJN 5, Laetitia DE KORT 6, Wout FEITZ 2 and Renske SCHAPPIN 7
1) Radboudumc, Paediatric Urology, Nijmegen, NETHERLANDS - 2) Amalia Children's Hospital, Radboudumc, Pediatric Urology, Nijmegen, NETHERLANDS - 3) Wilhelmina Children's Hospital, University Medical Center Utrecht, Medical Psychology and Social Work, Utrecht, NETHERLANDS - 4) Isala, Urology, Zwolle, NETHERLANDS - 5) TOP voor Kinderen, TOP voor kinderen, Zevenaar, NETHERLANDS - 6) University Medical Center Utrecht, Urology, Utrecht, NETHERLANDS - 7) University Medical Center Utrecht, Surgery, Utrecht, NETHERLANDS
PURPOSE
Functional daytime urinary incontinence(DUI) affects up to 20% of 7-year-old children. Urotherapy is the first-line treatment and wearable alarm systems are frequently used to provide feedback, though success rates vary. A recent innovation in this field is the bladder sensor, which is a real-time ultrasonic sensor that emits an alarm when the child's bladder is full. The purpose of the bladder sensor is to help children interpret the bladder sensations that precede voiding, which might enable a more rapid learning curve in urotherapy, leading to fewer wetting accidents. The aim of this study was to evaluate the clinical effectiveness of incorporating the bladder sensor into urotherapy for children with DUI.
MATERIAL AND METHODS
A multi-center, double blinded, randomized controlled trial was set up for children with DUI between 6 and 16 years old. A sample size of 219 participants was calculated. Participants were randomized in a 1:1:1 ratio into urotherapy alone, urotherapy with bladder sensor and urotherapy with placebo bladder sensor. The primary outcome was the number of wetting accidents after three months, comparing the bladder sensor with the placebo. Secondary outcomes included wetting accidents after six months, the magnitude of the placebo effect and changes in quality of life.
RESULTS
A total of 223 children agreed to participate, from 416 children recruited across five medical centers, including a first-line clinic, general and academic hospitals. Baseline characteristics include a mean age of 7.98 years(SD 1.89) and 46.1% of participants being girls. At baseline, 13.7% of children were diagnosed with a neurodevelopmental disorder. The majority of children had an overactive bladder (57.1%), followed by voiding postponement(21.9%) and dysfunctional voiding(7.6%). Approximately 29% of children were therapy-naïve. Participants reported a median of 7(IQR 5-12) wetting accidents per week at baseline. Outcomes are currently being analyzed, thereby exceeding the initial abstract deadline, but will be available to present in June 2026.
CONCLUSIONS
We hereby present a prospective, multi-center, randomized controlled trial that includes a large cohort of children with functional DUI. This study introduces a novel approach to urotherapy, incorporating continuous bladder monitoring, potentially marking an important step forward in the management of DUI.
10:00 - 10:10
SN07-4 (NP)
Filine VAN DEN BOSCH and Paul VAN LEUTEREN
Novioscan B.V. - an Essity company, IQ Solutions, Nijmegen, NETHERLANDS
PURPOSE
The aim of this case series was to explore the feasibility and user experience of a wearable bladder sensor in managing daytime incontinence and enuresis. Recruitment targeted both children and adults; however, this report focuses exclusively on ten pediatric cases to assess outcomes and identify areas for improvement.
MATERIAL AND METHODS
Participants were recruited via an online platform. From 712 website visitors, 182 signed up, and 80 requested further information. After 45 eligibility interviews, 16 were selected to prospectively use the bladder sensor as intended (children and adults combined), of which 10 children tested the bladder sensor (6.5 to 14 years old). All had prior unsuccessful interventions such as bedwetting alarms, medication, and diapers. The test period ranged from baseline to over 3 months, with follow-up at 1-2 weeks, 1 month, and beyond 3 months. Each case was analyzed individually for prior history, goals, and device experience.
RESULTS
Outcomes varied across cases. One child (7-year-old boy) reduced daytime diaper use from 3-4 per day to 0-1, gaining bladder awareness and confidence. Another child (8-year-old boy) achieved complete dryness within two weeks, eliminating nightly diaper use. In some cases, users indicated usability improvements, such as a request for additional guidance in setting up the device (e.g. setting the correct bladder capacity for reminders or finding the right location on the belly), personalization of the reminders (e.g. vibration intensity), or the adhesive patches loosening while playing actively.
CONCLUSIONS
This case series highlights the potential of a wearable bladder sensor to improve continence in selected pediatric cases during day and/or night. As a result of the case series, device improvements regarding the initial onboarding of the device, personalization of reminders and device-adhesion to the lower abdomen will be initiated. Further studies with larger cohorts are warranted to confirm these findings.