Continence problems among young people

Löfroth Larsson G1, Engqvist H1

Research Type

Basic Science / Translational

Abstract Category

Paediatrics

Abstract 794
Non Discussion Abstract
Scientific Non Discussion Abstract Session 37
Incontinence Nocturnal Enuresis Quality of Life (QoL) Infection, Urinary Tract Prevention
1.None
Links

Abstract

Hypothesis / aims of study
Continence problems among young people are well known, but difficult to quantify and little described in the literature. A poll to assess continence problems among young people would identify needs and possible actions to support and help them overcome their continence problems for improved quality of life. One key question is: “How can continence advisors with limited resources reach the patient, establish effective cooperation and dialogue during the meeting with the patient and facilitate curing?”
Study design, materials and methods
Two individual polls within nine years assessing micturition and toileting habits among young people, 13-19 years old, were conducted. In total, the polls included 632 and 621 respondents respectively, 49% boys and 51% girls, were contacted and all responded to a given questionnaire. Ethical guidelines were followed and supervised by medical experts. Medical and statistical expertise for evaluation was provided.
Results
•	The first poll showed 9% of the boys and 0.7% of the girls suffered from nocturnal enuresis.
•	Following professional training and education, the second poll showed that 2.1% of the boys and 0.6% of the girls suffered from nocturnal enuresis.
•	The first poll showed that the level of incontinence was 22% among the girls and 11% among the boys, which shows the importance of addressing the problem.
•	The second poll after nine years and professional training and education, showed that 7.6% of the girls and 5.5% of the boys had incontinence problems.
•	Wee problems are sensitive to talk about and 37.5% of the girls and 50% of the boys did not ask for support for their problem.
•	The first polls showed that 20% of the girls and 4.6% of the boys had urinary tract infections.
•	The second poll showed that 26.4% of the girls and 5.3% of the boys had urinary tract infections.
•	The results showed that approximately 20% of the respondents did not use school toilets.
Interpretation of results
Selected country regulations and recommendations state: 
−	“the patient and his/her parents/family/care-givers are informed and participate”
−	“the patient shall be given clear (understandable) information about his/her health conditions and what treatment methods are available.”
Verbal communication alone might not always provide understanding about the symptoms and possible treatment methods and it is very important for young people that adults participate in the treatment. Visual materials using pictures can be very valuable in helping interact effectively with the young patient. The pictures make it easier for the patient to understand his/her anatomy and the individual bladder training program, as well as helping them participate actively in the treatment. The pictures have many times been the entry to a good bladder training program that has provided successful results for the patient.
In addition to the study a booklet to identify bladder problems was developed as a guide in communication with the young people and care-givers to create a dialogue about the problem and possible solutions and therapies. To facilitate dialogue graphic pictures show various situations when they may experience continence problems. It also presents a structured way to help them solve their problems.
With this method, the time meeting the patient has become shorter and increased understanding and motivation in the patient was observed. This saves time for both the patient and the continence adviser.
•	Most children and young people visiting a continence clinic because of various urinary problems do so because their parents have asked for help. Only a limited number of young people are not self-motivated, but supported by their parents, they come to the clinic at the given time.
•	If routines are developed early, continence problems among young people can hopefully be prevented at adult age.
•	The toilet environment plays a major role in maintaining good micturition habits.
Concluding message
Lessons learned high-light the continence problems among young people. Methods for assessment, dialogue, medical treatments need further development for relevant assistance. Another aspect shows opportunities in the design of children’s toilets to encourage regular toileting, ideas that may be relevant for adults as well to learn better continence management.
The key lessons learned are:
•	Significant improvement after long-term studies
•	Need to learn proper wee / poo habits
•	Need for educated uro-consultants
•	Cooperation between school doctors and nurse and hospital clinics
•	Children have no idea about the wee
•	They hate the wee and punish themselves
•	Need to improve school toilets
•	Peace & quiet & clean toilets
Lessons learned for the continence advisor:
•	Be concrete and clear in communication
•	UTIs are increasing at lower age mainly for girls but not as much for boys
•	Question: Has the young person had an early sex debut?
•	Give the patient advice to wee after sex
Figure 1
Disclosures
<span class="text-strong">Funding</span> None <span class="text-strong">Clinical Trial</span> No <span class="text-strong">Subjects</span> Human <span class="text-strong">Ethics Committee</span> Prof. Anna-Lena Hellström <span class="text-strong">Helsinki not Req'd</span> It was an anomymous poll <span class="text-strong">Informed Consent</span> Yes