Pediatric Incontinence (eBook)

Evaluation and Clinical Management

Israel Franco, Paul Austin, Stuart Bauer, Alexander von Gontard, Yves Homsy (Herausgeber)

eBook Download: PDF

2015
John Wiley & Sons (Verlag)
978-1-118-81477-2 (ISBN)

Infos

Pediatric incontinence: evaluation and clinical management offers urologists practical, 'how-to' clinical guidance to what is a very common problem affecting up to 15% of children aged 6 years old.
Introductory chapters cover the neurophysiology, psychological and genetic aspects, as well as the urodynamics of incontinence, before it moves on to its core focus, namely the evaluation and management of the problem.  All types of management methods will be covered, including behavioural, psychological, medical and surgical, thus providing the reader with a solution to every patient's specific problem.

The outstanding editor team led by Professor Israel Franco, one of the world's leading gurus of pediatric urology, have recruited a truly stellar team of contributors each of whom have provided first-rate, high-quality contributions on their specific areas of expertise.  Clear management algorithms for each form of treatment support the text, topics of controversy are covered openly, and the latest guidelines from the ICCS, AUA and EAU are included throughout. 
Perfect to refer to prior to seeing patients on the wards and in the clinics, this is the ideal guide to the topic and an essential purchase for all urologists, pediatric urologists and paediatricians managing children suffering from incontinence.

EDITOR AFFILIATIONS

Israel Franco, MD, Professor of Urology, New York Medical College, Director of Pediatric Urology, Maria Fareri Children's Hospital, Valhalla, New York, USA

Paul F. Austin, M.D, F.A.A.P., Director of Pediatric Urology Research, Associate Professor of Urologic Surgery, St. Louis Children's Hospital, Washington University School of Medicine, USA

Stuart Bauer, MD, Professor of Surgery (Urology), Harvard Medical School, Senior Associate, Department of Urology, Boston Children's Hospital, Boston, USA

Prof. Dr. Alexander von Gontard, Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany

Yves Homsy MD, Clinical Professor of Urology, University of South Florida, Tampa, Tampa, FI

Inhalt

Title Page 5
Copyright Page 6
Contents 9
Contributors 13
Preface 17
Section 1 Pathophysiology of bowel and bladder dysfunction 19
Chapter 1 Neurophysiology of voiding 21
Anatomy of the lower urinary tract 21
Afferent mechanisms 23
Spinal cord and brainstem 24
Cortex 26
Efferent mechanisms, peripheral 26
Efferent mechanisms, central 27
Development of urinary continence 29
Conclusion 30
References 30
Chapter 2 Neurophysiology of defecation 33
Normal defecation patterns 33
Functional anatomy of colon, rectum, and anus 33
Colorectal motility and defecation 35
References 38
Chapter 3 Functional brain imaging in bowel and bladder control 39
Introduction 39
Background 40
Anterior cingulate cortex 42
Prefrontal cortex 45
PAG and PMC 48
Conclusion 50
Acknowledgments 50
References 50
Section 2 Epidemiological aspects of bowel and bladder dysfunction 53
Chapter 4 The epidemiology of childhood incontinence 55
Introduction 55
Nocturnal enuresis 58
Daytime urinary incontinence 67
Fecal incontinence 71
Conclusion 74
References 74
Chapter 5 Quality of life factors in bladder and bowel dysfunction 79
Quality of life factors in BBD 79
Neurogenic BBD 82
References 83
Chapter 6 Psychological aspects in bladder and bowel dysfunction 85
Introduction 85
Subclinical symptoms 85
Clinical comorbid disorders 86
Differences in types of incontinence 87
Conclusions and recommendations 88
Appendix: Short screening instrument for psychological problems in enuresis (SSIPPE) 88
Short screening instrument for psychological problemsin enuresis (SSIPPE) 88
Strengths and Difficulties Questionnaire (SDQ) 89
References 90
Chapter 7 Neuropsychiatric disorders and genetic aspects of bowel or bladder dysfunction 91
Introduction 91
Cortical thinning and neuropsychiatric disorders 93
Right frontal lobe and incontinence 96
ADHD 98
Lateral prefrontal cortex 99
White matter abnormalities 101
How does this correlate to children? 101
Conclusion 103
References 103
Section 3 Evaluation of bowel and bladder dysfunction 107
Chapter 8 Urodynamics in the pediatric patient 109
Introduction 109
Evaluation of children prior to UDS 109
Preparation of the child for UDS 110
Invasive urodynamics 111
Catheter and electrode placement 111
Cystometry 112
Uroflowmetry 114
Timing of UDS 114
Conclusion 115
References 115
Chapter 9 Uroflowmetry and postvoid residual urine tests in incontinent children 117
Introduction 117
Interpretation 118
Conclusion 122
References 123
Chapter 10 Evaluation of the child with voiding dysfunction 125
Introduction 125
History and physical examination 125
Questionnaires and their validity 126
Classification and major features of voiding dysfunction disorders 126
The bowel issue 133
References 136
Chapter 11 Evaluation of constipation and fecal incontinence 139
Definitions 139
Normal defecation pattern 139
Epidemiology 140
Medical history 141
Physical examination 143
Laboratory investigations 144
Abdominal radiograph 144
Colonic transit time measurement 144
Transabdominal rectal ultrasonography 145
Contrast enema 145
Defecography 145
Magnetic resonance imaging 146
Anorectal manometry 146
Colonic manometry 146
Conclusion 147
References 147
Section 4 Treatments of functional bowel and bladder dysfunction 149
Chapter 12 Implementation of urotherapy 151
Implementation of urotherapy 151
Specific interventions 153
Bowel therapy 154
References 155
Chapter 13 The concept of physiotherapy for childhood BBD 157
The concept of physiotherapy for childhood bladder and bowel dysfunction 157
Conclusion 161
References 161
Chapter 14 Biofeedback for the treatment of functional voiding problems 163
Introduction 163
The dietary log and voiding chart 163
Toilet posture 164
Relaxation biofeedback training 164
Biofeedback efficacy 168
Conclusion 168
References 168
Chapter 15 Pharmacotherapy of the child with functional incontinence and retention 171
Lower urinary tract symptom management 171
Overactive bladder 171
Urinary retention/incomplete bladder emptying 174
Antidepressants 175
Other drugs 178
Conclusion 178
References 178
Chapter 16 Treatment of functional constipation and fecal incontinence 181
Treatment of functional constipation in infants and toddlers 181
Treatment of functional constipation with and without fecal incontinence in children and adolescents 182
Treatment of nonretentive fecal incontinence 186
References 187
Chapter 17 Peripheral tibial nerve stimulation therapy for the treatment of functional voiding problems 189
Introduction 189
Technique 190
Mechanism of action of PTNS 190
PTNS in pediatric lower urinary tract dysfunction 190
Conclusions 191
References 191
Chapter 18 Sacral nerve stimulation therapy for the treatment of functional voiding problems 193
Introduction 193
Mechanism of action of SSN 193
Patient selection for SSN 194
Implantation technique 195
Outcomes of SSN 197
Conclusions 198
References 198
Chapter 19 Superficial stimulation therapy for the treatment of functional voiding problems 201
Introduction 201
Clinical results 202
Comparative studies with other methods 203
Tens for constipation 204
Enuresis 204
Conclusion 205
References 205
Chapter 20 Botulinum toxin in the treatment of the functional bladder 207
Use of botulinum toxin in children: Introduction 207
Biochemical 209
Use of Botox in pediatric urology 210
Technique of injection 213
Dose, patient safety, and antibodies 214
Conclusion 217
References 217
Chapter 21 Psychological management of BBD 219
Introduction 219
Psychological aspects in evaluation of BBD 219
Psychological management of BBD 220
Conclusion 222
References 223
Section 5 Nocturnal enuresis 225
Chapter 22 Pathophysiology of nocturnal enuresis 227
Introduction 227
Nocturnal polyuria 227
Underlying pathogenic mechanisms 228
Reduced nocturnal bladder reservoir function 230
Disturbed sleep/arousal function 232
Genetic factors 233
References 234
Chapter 23 Evaluation of the enuretic child 239
Tools 239
Evaluation strategy 242
References 244
Chapter 24 Management of monosymptomatic nocturnal enuresis (enuresis) 245
Introduction 245
Who should start the treatment? 246
When to start the treatment? 246
Treatment 247
Desmopressin therapy [15, 54–57] 250
Conclusion 256
References 256
Chapter 25 Psychological aspects in evaluation and management of nocturnal enuresis (NE) 263
Introduction 263
Different types of nocturnal enuresis and different types of psychological problems 263
Children with special needs 264
Psychological aspects in evaluation 265
Psychological aspects of treatment 266
Conclusions 267
Appendix 25.A Short screening instrument for psychological problems in enuresis (SSIPPE) 267
Short screening instrument for psychological problemsin enuresis (SSIPPE) 267
Strengths and difficulties questionnaire (SDQ) 268
Other questionnaires 269
Child behavior checklist 269
Behavior assessment system for children: Secondedition (BASC-2) 269
References 269
Section 6 Neurogenic bladder and bowel dysfunction 271
Chapter 26 Diagnostic evaluation in children with neurogenic bladder 275
Introduction 275
Diagnostic modalities 276
Evaluation of the neonate suspected for neuropathic bladder dysfunction 276
Toddler and school age 277
Puberty and adolescence 278
The wet child with paralytic sphincter 278
UDS: Specific pitfalls 278
Ultrasound, DMSA scan, and spinal MRI 279
References 279
Chapter 27 Medical management of the neurogenic bladder 281
Lower Urinary Tract Physiology 281
Medical management of the overactive bladder 283
References 287
Chapter 28 Treatment of constipation and fecal incontinence: Neuropathic 291
Medical management 291
Surgical options 292
Surgical technique: In situ appendicocecostomy 292
MACE options when the appendix is absent 294
Minimally invasive MACE procedures 294
Left colon MACE procedure 295
Minimally invasive percutaneous cecostomy tube 295
Enema protocols for MACE 296
Outcomes and complications of the MACE procedure 296
References 297
Chapter 29 Neuromodulation for neurogenic bladder in pediatric spinal dysraphism 299
IVES (Intravesical Electrical Stimulation) 300
TENS 304
PTNS 305
Sacral nerve stimulation 305
Summary 307
References 307
Chapter 30 Botulinum toxin in the treatment of neuropathic lower urinary tract dysfunction 311
Pharmacology 311
Clinical application 311
BTX injection technique 313
Conclusion 314
References 315
Chapter 31 The surgical management of the neurogenic bladder 317
Introduction 317
Evaluation of the patient with NGB 318
Surgical reconstruction: General principles 319
Summary 324
References 324
Chapter 32 Surgery for bowel dysfunction 327
Introduction 327
Antegrade continence enemas 328
Cecostomy 330
Diversion 331
Colonic resection 333
Conclusion 334
References 334
Chapter 33 Neurological surgery for neurogenic bladder dysfunction 335
Introduction 335
Tethered spinal cord 335
Brain anomalies 341
Other spinal cord lesions and vertebral anomalies 341
Conclusions 342
References 342
Index 345
EULA 357

Produkt-Details

• Erscheint lt. Verlag: 3.9.2015
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Pädiatrie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Urologie
• Schlagworte: bedwetting • bladder continence • bladder control • Bladder Dysfunction • child incontinence • incontinence • Medical Science • Medizin • Pädiatrie • Pädiatrie • Pediatric incontinence • Pediatrics • Pediatric Urology • Urologie • Urology • Voiding Dysfunction
• ISBN-10: 1-118-81477-0 / 1118814770
• ISBN-13: 978-1-118-81477-2 / 9781118814772