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Randomized Controlled Trial
. 2019 Jun 27;17(3):eAO4602.
doi: 10.31744/einstein_journal/2019AO4602.

Pelvic floor muscle training alone or in combination with oxybutynin in treatment of nonmonosymptomatic enuresis. A randomized controlled trial with 2-year follow up

[Article in English, Portuguese]
Renata Martins Campos  1 , Adélia Correia Lúcio  2 , Maria Helena Baena de Moraes Lopes  1 , Claudia Rosenblatt Hacad  3 , Maria Carolina Ramos Perissinotto  1 , Howard I Glazer, Carlos Arturo Levi D'Ancona  1
Affiliations
Randomized Controlled Trial

Pelvic floor muscle training alone or in combination with oxybutynin in treatment of nonmonosymptomatic enuresis. A randomized controlled trial with 2-year follow up

[Article in English, Portuguese]
Renata Martins Campos et al. Einstein (Sao Paulo). .

Abstract
in English, Portuguese

Objective: To compare the results of the standard urotherapy alone and associated with pelvic floor muscle training alone, and in combination with oxybutynin in treatment of nonmonosymptomatic nocturnal enuresis.

Methods: A total of 38 children aged 5 to 10 years were randomized into three groups: Group I (n=12) that was submitted to standard urotherapy; Group II (n=15), standard urotherapy associated with pelvic floor muscle training; and Group III (n=11), standard urotherapy associated with pelvic floor muscle training and oxybutynin; the treatment lasted 12 weeks. The assessment tools used were playful bladder diary, and a 48-hour bladder diary, before and after treatment. After 2 years, patients were assessed by telephone using a standardized questionnaire.

Results: The data of children from the three groups were homogeneous at baseline. After 12-week treatment, all children showed improved symptoms and signs of nonmonosymptomatic nocturnal enuresis, but the differences were not significant among the groups. After 2 years, the three groups showed maintenance of treatment results, but no differences among them.

Conclusion: All treatment modalities were effective regarding improved enuresis and lower urinary tract symptoms, but the sample was not large enough to show differences among groups.

Objetivo: Comparar os resultados da uroterapia padrão isolada e associada ao treinamento dos músculos do assoalho pélvico isoladamente e em combinação com a oxibutinina no tratamento da enurese noturna não monossintomática.

Métodos: Trinta e oito crianças entre 5 e 10 anos de idade foram randomizadas em três grupos: Grupo I (n=12) realizou uroterapia padrão; Grupo II (n=15) realizou uroterapia padrão associada ao treinamento muscular do assoalho pélvico; e Grupo III (n=11) realizou uroterapia padrão associada ao treinamento muscular do assoalho pélvico e oxibutinina. O tratamento teve duração de 12 semanas. Os instrumentos de avaliação foram diário miccional lúdico e diário miccional de 48 horas, antes e depois do tratamento. Após 2 anos, os pacientes foram avaliados por telefone, usando um questionário padronizado.

Resultados: Os dados das crianças dos três grupos eram homogêneos no início do estudo. Após 12 semanas de tratamento, todas as crianças apresentaram melhora em relação aos sinais e sintomas de enurese noturna não monossintomática, mas as diferenças não foram significativas entre os grupos. Depois de 2 anos, os resultados do tratamento se mantiveram nos três grupos, mas não houve diferenças entre os grupos.

Conclusão: As três modalidades de tratamento foram eficazes na melhora da enurese e dos sintomas do trato urinário inferior, mas o tamanho da amostra não foi grande o suficiente para mostrar diferenças entre os grupos.

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Figures

Figure 1
Figure 1. Playful bladder diary
Figure 2
Figure 2. Proper voiding posture for girls
Figure 3
Figure 3. Median of the number of dry nights measured by the playful bladder diary, assessed 7 days before the beginning of treatment (baseline), after 4 weeks of treatment (Time 1), after 8 weeks of treatment (Time 2) and after 12 weeks of treatment (Time 3)
See this image and copyright information in PMC

References

    1. Nevéus T. Pathogenesis of enuresis: towards a new understanding. Int J Urol. 2017;24(3):174–182. - PubMed
    1. Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: Update report from the standardization committee of the International Children’s Continence Society. Neurourol Urodyn. 2016;35(4):471–481. - PubMed
    1. Franco I, von Gontard A, De Gennaro M, International Childrens’s Continence Society Evaluation and treatment of nonmonosymptomatic nocturnal enuresis: a standardization document from the International Children’s Continence Society. J Pediatr Urol. 2013;9(2):234–243. - PubMed
    1. Fernández-Pineda I, Pérez Espejo MP, Fernández Hurtado MA, Barrero Candau R, García Merino F. Biofeedback and electrostimulation in the treatment of non monosymptomatic enuresis. Cir Pediatr. 2008;21(2):89–91. Spanish. - PubMed
    1. Ebiloglu T, Ergin G, Irkilata HC, Kibar Y. The biofeedback treatment for non-monosymptomatic enuresis nocturna. Neurourol Urodyn. 2016;35(1):58–61. - PubMed

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