Abstract
Background: Dysfunctional voiding (DV) is the most common chief complaint evaluated in the outpatient pediatric urology setting. Children report that wetting their pants in school is one of the most traumatic life events. DV has been associated with urinary tract infection (UTI), attention-deficit disorder, and low self-esteem. Timed voiding is recommended for most children, although little evidence in the literature exists to support its success.
Purpose: The author aims to describe the characteristics of children with DV, evaluate the effectiveness of timed voiding, and evaluate the effectiveness of a vibratory watch in addition to timed voiding.
Methods: A retrospective medical record chart review of 96 pediatric patients was conducted. Inclusion criteria consisted of being a patient between the ages of 4 and 18 years at the author's urban, tertiary hospital Bowel and Bladder Clinic with the diagnosis of DV, habit disturbance, or enuresis. A chart abstraction tool based on items from the Dysfunctional Voiding and Incontinence Symptoms Scoring tool was developed and utilized. Multiple one-way analyses of variance were performed to compare changes in the Dysfunctional Voiding and Incontinence Symptoms Scoring change score based on treatment and patient characteristics.
Results: A statistically significant symptom improvement was found for children. Girls and children with a previous history of UTI demonstrated a significantly greater improvement. Although there was a significant change score by gender and history of UTI for the total group, this was not sustained when the sample was split into those who required and did not require anticholinergic medication in addition to timed voiding. There was no significant difference among the children who used a vibratory watch.
Conclusion: The author demonstrated the effectiveness of timed voiding as the first-line therapy of pediatric DV.