Which treatments do children with newly diagnosed non-organic urinary incontinence receive? An analysis of 3,188 outpatient cases from Germany

Authors


  • Christopher Chapple led the review process.

  • Conflicts of interest: CS has received a lecture fee from Apogepha. CB has received a lecture fees from Actelion, Ferring and Novartis. FH, JG and GG declare no conflict of interest.

Abstract

Aims

Objectives of this study were to examine the administrative incidence of urinary incontinence in children and to assess related outpatient health services utilization in this cohort.

Methods

Data of a statutory health insurance company were analyzed and outpatients from 1 to 18 years of age with a first recorded ICD-10 code for non-organic urinary incontinence during a 1-year-period (2007) were identified. For this cohort, the prescription of desmopressin, antispasmodics, non-selective monoamine reuptake inhibitors, alarm devices, and incontinence pads in the quarter of the first diagnosis and in the following one (i.e., 6 months) was evaluated with respect to age and gender.

Results

3,188 patients (59.4% male; mean age 6.8 years) matched the inclusion criteria, of whom 25.4% were under 5 years old. 7.9% were prescribed desmopressin, 7.4% received urinary antispasmodics, and 7.0% were treated with alarm devices. For 77.9% of patients, no specific incontinence-related treatments were prescribed. We found considerable differences in treatment patterns between age groups, with patients ≥7 years receiving desmopressin more frequently than alarm devices. Regarding gender differences, the proportion of males treated with alarm devices (prevalence ratio [PR] 1.46; 95% confidence interval [95%CI] 1.11–1.92) and at least one specific treatment (PR 1.19; 95%CI 1.04–1.35) remained statistically significantly higher, even after adjusting for age.

Conclusions

In our study, we found evidence that treatment modalities only partly comply with the current guidelines for treatment of children and adolescents with non-organic urinary incontinence. Therefore, the dissemination of current guidelines remains a major educational goal. Neurourol. Urodynam. 31:93–98, 2012. © 2011 Wiley Periodicals, Inc.

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