Systematic approach to the treatment of urinary incontinence in children with normal development and in children with developmental disorders.

Urinary incontinence in children, both in children with normal development and in children with developmental disorders remains a major problem. Five percent of the 7 years old normal developed children suffer daytime urinary incontinence. In children with developmental disorders this may even be up to 85%.

In addition to the important physical discomforts incontinence also has an important psychological, social and family impact on the child and his environment. Children suffering incontinence often have low self-esteem. Moreover, the social pressure on these children and their parents is systematically increasing. Children aged 2.5years are no longer considered ready for school if they still have an incontinence problem.

Based on literature and on our own experience at the department of pediatric urology at the Ghent University Hospital, there are a variety of treatment modalities. These range from urotherapy and physiotherapy, through medicinal approacheswith anti-muscarinics and sympathomimetics, to electrical neurostimulation and injection of botulinum-toxin into the detrusor. Many of these treatments are off label and often have important financial implications for the family.

The lack of a scientifically substantiated system in these treatments is important. The order and combination of therapies, in the treatment of urinary incontinence, is often done at random.

This not only leads to doubts among the practitioners, but is also the cause of low compliance among many parents.

Moreover, the treatment is often multidisciplinary, including pediatric urologists, pediatricians and physiotherapists, whereby the treatment offered also shows little systematicity.

The pediatric urology department, the pediatric nephrology department and pelvic floor physiotherapist of the Ghent University Hospital have a great deal of experience, based on treating a very large population of children with urinary incontinence, both in normally developing children and in children with a developmental disorder.

Based on the retrospective analysis of the results with the aforementioned treatment methods, it should be possible in a second step to realize a systematized systematic approach to urinary incontinence in this patient population in a prospective setting.

This study can perfectly be the subject of a PhD thesis