Micturition Reeducation in Children With Cerebral Palsy
- Conditions
- Daytime Urinary Incontinence
- Interventions
- Other: urotherapy with or without pharmacotherapy
- Registration Number
- NCT02364063
- Lead Sponsor
- University Hospital, Ghent
- Brief Summary
This study evaluates the effectiveness of a voiding reeducation program as treatment for incontinence in children with a brain injury.
- Detailed Description
Children with cerebral palsy (CP) (Rosenbaum, 2007) gain bladder and bowel control at older age compared to typical developing children (Ozturk, 2006). The incidence of urinary incontinence during day and night, fecal incontinence and constipation is higher in this population.
Incontinence in children is often treated with urotherapy. This is a nonsurgical, nonpharmacological treatment for lower urinary tract dysfunctions. Standard urotherapy is noninterventional and it includes giving information, instructions, advice regarding life-style, fluid intake and bladder diaries. Additionally specific interventions can be used, such as: various forms of pelvic floor training, behavioral modification, biofeedback, electrical stimulation and catheterization (Neveus, 2006). Recent research has proven urotherapy to be successful for the treatment of children with daytime incontinence (Mulders, 2010).
Despite the high prevalence of incontinence in children with CP the possible treatment strategies in this population are poorly investigated. Far too often, urinary incontinence in children with CP is considered a normal, unavoidable and even a minor problem.
Aim: Investigate the influence of individualized urotherapy on the (in)continence of children with CP.
The included children with CP will be randomized and stratified for type of CP and mental abilities into 2 groups: the intervention group and the control group. The intervention group will receive immediate therapy. After one year of therapy, a follow- up of 6 months will be applied. The control group will start 6 months later and information will be used as control group. Incontinent children without CP will receive therapy and will also act as control group.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 40
- Daytime urinary incontinence with or without enuresis and/or fecal incontinence
- Cerebral palsy (Arms of children with CP)
- Normal development (Arms of children without CP)
- Isolated urinary tract infections
- Isolated enuresis
- Isolated dysfunctional voiding
- Isolated fecal incontinence
- Anatomical abnormalities
- History of genitourinary or renal surgery
- Medication for incontinence during the last 3 months
- Pelvic reeducation during the last 6 months
- other neurologic problems influencing continence
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Children with CP - Therapy urotherapy with or without pharmacotherapy Children receive incontinence treatment during one year, after which a follow-up period of 6 months will be applied. Intervention includes standard urotherapy with or without pharmacotherapy/specific urotherapy Children without CP urotherapy with or without pharmacotherapy Children receive incontinence treatment during 1 year. Intervention includes standard urotherapy with or without pharmacotherapy/specific urotherapy
- Primary Outcome Measures
Name Time Method Subjective report of change in urinary incontinence measured by questionnaire Baseline and 3-6-12 months + follow-up
- Secondary Outcome Measures
Name Time Method voiding variables and pelvic floor activity during micturition measured by uroflow/EMG Baseline and 3-6-12 months Uroflow and pelvic floor EMG + postmictional residue
Lower urinary tract symptoms (LUTS) measured by questionnaire baseline and 6-12 months Drinking behaviour measured by drinking and voiding charts Baseline and 6-12 months Constipation/fecal incontinence measured by ROME III criteria Baseline and 6-12 months
Trial Locations
- Locations (1)
University Hospital, Ghent
🇧🇪Ghent, Belgium