BERKELEY, CA (UroToday.com) - A study by State University of Campinas (Unicamp-SP) found that physical therapy can help reduce urinary incontinence in children. Non-monosymptomatic enuresis (NMNE), or bedwetting, is a voiding dysfunction of children, one that creates a lot of concern for parents as well as discomfort for patients. On average, it impacts 5% to 10 % of the population in the age range of 5 to 10 years and is characterized by involuntary loss of urine during the day and/or night. The etiology of enuresis is multifactorial and is hypothesized to be related to problems with arousal, small bladder capacity, and large overnight urine production. Daytime incontinence is associated with various comorbid conditions such as urinary tract infection, vesicoureteral reflux, constipation, and behavioral troubles.
In research conducted by physiotherapist Renata Martins Campos, all children were evaluated by anamnesis, urinalysis, urine culture, as well as by entries in a "playful" voiding diary. The entire group was comprised of 47 children, and the children were randomized into 2 groups at the Clinic of Urology, Pediatric Hospital of Unicamp. One of the groups was treated with oxybutynin as well as some associated behavioral therapy, which recommended a change of habits such as reeducation of fluid. The other group received pelvic floor muscle training, having been treated with behavioral therapy and a protocol of 5 types of exercises to strengthen muscle sites such as abdominals, adductors and the gluteals. They were followed for 3 months, weekly or monthly according to the group, and the children were instructed to repeat at home twice a week.
The first group, treated with medication, presented in the first month with 12 dry nights, in the second month, 13, and in the third month, 16. In the second (pelvic floor muscle training) group, 15 dry nights were attained during the first month, 21 dry nights in the second month, and 24 dry nights in the last month, thus demonstrating the effectiveness of pelvic floor muscle training. The researcher warns that when the problem is not handled in a timely and appropriate manner, there is the prospect that the dysfunction will advance beyond childhood into adolescence. "This framework takes the individual through various situations of constraints, including a wet bed and waking up to a very strong odor released by urinary loss," says the physiotherapist.
Written by:
Renata Martins Campos as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Universidade Estadual de Campinas, Campinas, SP, Brazil
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