Profiles of patients with urinary incontinence in the Department of Child Health, Cipto Mangunkusumo Hospital

  • Eveline P N
  • Taralan Tambunan
  • Sri Rezeki S Hadinegoro
Keywords: urinary incontinence, myelodysplasia, renal failure, urinary tract infection

Abstract

Background Urinary incontinence (UI) in children is a form of
wetting. Early diagnosis and treatment are mandatory to avoid
complications such as recurrent urinary tract infections (UTI),
vesicoureteral reflux (VUR), or renal damage.
Objective To study the profiles and clinical course of UI in chil-
dren treated in Cipto Mangunkusumo Hospital.
Methods The study was divided into 2 parts. The first part was a
review of patients with UI at Cipto Mangunkusumo Hospital from
January 2000 to December 2003. The second was a case series
of patients followed up for at least 6 months.
Results There were 35 UI patients aged 3 months to 16 years,
mostly between 1 to 5 years old, 16 were males and 19 females.
The most prevalent etiology was myelodysplasia (15 cases) fol-
lowed by posterior urethral valve, and bladder tumor. The most
prominent clinical presentation of neurophatic bladder-sphincter
dysfunction was wetting, while those of patients with structural in-
continence and non-neuropathic bladder-sphincter dysfunction
were fever and polakysuria. Most patients had been suffering from
renal insufficiency since their first visit. Clean intermittent catheter-
ization (CIC) was the treatment of choice. In a six-month follow-up
of 14 patients who received adequate treatment, renal function
could be maintained at relatively stable condition in most cases.
Conclusions Myelodysplasia was the most common etiology of
UI. Most patients had renal insufficiency or renal failure since their
first visit, reflecting a extended period of relapse before patients
seek medical help. Renal function can be maintained by adequate
treatment in most cases

Author Biographies

Eveline P N
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Taralan Tambunan
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Sri Rezeki S Hadinegoro
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.

References

1. Atala A, Bauer SB. Bladder dysfunction. In: Barratt
TM, Avner ED, Harmon WE, editors. Pediatric Neph-
rology. 4th ed. Baltimore: Lippincott William
&Wilkins; 1999. p. 913-31.
2. Bauer SB. Neurogenic bladder dysfunction. In:
Edelmann CM, Bernstein J, Meadow SR, Spitzer A,
Travis LB, editors. Pediatric kidney disease. 2nd ed. Bos-
ton: Little, Brown and Company; 1992. p. 2085-109.
3. Varlam DE, Dippell J. Non-neurogenic bladder and
chronic renal insufficiency in childhood. Pediatr
Nephrol 1995;9:1-5.
4. Rushton HG. Enuresis. In: Kher KK, Makker SP, edi-
tors. Clinical pediatric nephrology. New York: Mc
Graw-Hill; 1992. p. 339-419.
5. Mundy AR. The neuropathic bladder. In: Postlethwaite
RJ, editor. Clinical paediatric nephrology. 2nd ed. Ox-
ford: Butterworth-Heinemann; 1994. p. 319-33.
6. Van Gool JD. Disorders of micturition. In: Postlethwaite
RJ, editor. Clinical paediatric nephrology. 2nd ed. Ox-
ford: Butterworth-Heinemann; 1994. p. 59-74.
7. Van Gool JD, Bloom DA, Buttler RJ. Djurhuus JC, Hjalmas
K, De Jong TPVM et al. Conservative management in chil-
dren. In: Abrams P, Khoury S, Wein A, editors. Incontinence.
Proceedings of the 1st International Consultation on Incon-
tinence; 1998 June 28- July 1; Monaco. p. 487-549.
8. Homma Y, Batista JE, Bauer SB, Griffiths DJ, Hilton P,
Kramer G et al. Urodynamic. In: Abrams P, Khoury S,
Wein A, editors. Incontinence. Proceedings of the 1st
International Consultation on Incontinence; 1998 June
28- July 1; Monaco. p. 351-99.
9. Hunskaar S, Arnold EP, Burgio K, Diokno AC, Herzog
AR, Mallett VT. Epidemiology and natural history of
urinary incontinence. Incontinence. Proceedings of the
1st International Consultation on Incontinence; 1998
June 28- July 1; Monaco. p. 197-226.
10. Tanago EA. Urinary incontinence. In: Tanago EA, Mc
Aninch JW, editors. Smith General Urology. 14th ed.
California: Appleton and Lange; 1995. p. 536-51.
11. Tambunan T. Inkontinensia urin pada anak. Sari
Pediatri 2000;2:163-9.
12. International Reflux Study Committee: Medical ver-
sus surgical treatment of primary vesicoureteral reflux:
a prospective international reflux study in children. J
Urol 1981;125:237-8.
13. Sekarwarna N, Rachmadi D, Hilmanto D. Gagal ginjal
kronik. In: Alatas H, Tambunan T, Trihono PP, Pardede
SO, editors. Buku ajar nefrologi anak. 2nd ed. Jakarta:
Balai Penerbit Fakultas Kedokteran Universitas Indo-
nesia; 2002. p. 509-30.
14. Ridgen SPA. Chronic renal failure. In: Postlethwaite,
editor. Clinical pediatric nephrology. 2nd ed. Oxford:
Butterworth Heinemann; 1994. p. 266-81.
15. Schwartz GJ, Haycock GB, Edelman CM, Spitzer A. A
simple estimate of glomerular filtration rate in chil-
dren derived from body length and plasma. Pediatrics
1976;58:259-63.
16. Walker WA, Hendricks KM. Pediatric nutrition. Phila-
delphia: WB Saunders; 1985.
17. Cass AS, Luxenberg M, Johnson CF, Gleich P. Man-
agement of the neurogenic bladder in 413 children. J
Urol 1984;132:521-5.
18. Pereira PL, Espinosa L, Urrutina MJM, Navarro RLM,
Jaureguizar E. Posterior urethral valves: prognostic fac-
tors. Int Braz J Urol 2003;91:687-90.
19. Pereira PL, Urrutina MJM, Espinosa L, Navarro RLM,
Jaureguizar E. Bladder dysfunction as a prognostic
factorin patient with posterior urethral valves. Int Braz
J Urol 2002;90:308-11.
20. Onuora VC, Mirza K, Koko AH, Al Turki M, Meabed
AH, Al Jawini N. Prognostic factors in Saudi chil-
dren with posterior urethral valves. Ped Nephrol
2000;14:221-3.
21. Connor JP, Burdige KA. Long term urinary continence
and renal function in neonates with posterior urethral
valves. J Urol 1990;144:1209-11.
22. Soler D, Borzyskowski M. Lower urinary tract dysfunc-
tion in children with central nervous system tumours.
Arch Dis Child 1998;79:344-47.
23. Dincer F, Dincer C, Baskaya MK. Results of combined
treatment of paediatric intraspinal tumours. Paraple-
gia 1992;30:718-28.
24. Van Gool JD, Hjalmas K, Tamminen-Mobius T, Olbing
H. Historical clues to the complex of dysfunctional
voiding, urinary tract infection and vesicoureteral re-
flux - The International Reflux Study in Chidren. J
Urol 1992;148:1699-1702.
25. Cohen RA, Rushton HG, Belman AB, Kass EJ, Majd
M, Shaer C. Renal scarring and vesicoureteral re-
flux in children with myelodysplasia. J Urol
1990;144:541-4.
26. Kaplan WE, Firlit CF. Management of reflux in the
myelodysplastic child. J Urol 1983;129:1195-7.
27. Sidi AA, Peng W, Gonzalez R. Vesicoureteral reflux in
children with myelodysplasia natural history and re-
sults of treatment. J Urol 1986;136:329-31.
28. Rushton HG, Majd M. Dimercaptosuccinic acid renal
scintigraphy for the evaluation of pyelonephritis and
scarring: a review of experimental and clinical stud-
ies. J Urol 1992;148:1726-32.
29. Ottolini MC, Shaer CM, Rushton HG, Majd M,
Gonzalez EC, Patel KM. Relationship of asymp-
tomatic bacteriuria and renal scarring in children
with neuropathic bladders who are practicing
clean intermittent catheterization. J Pediatr
1995;127:368-72.
30. Schlager TA, Dilks S, Trudell J, Whittam TS, Hendley
O. Bacteriuria in children with neurogenic bladder
treated with intermittent catheterization: Natural his-
tory. J Pediatr 1995;126:490-6.
31. Szucs K, O’Neil KM, Faden H. Urinary findings in as-
ymptomatic subjects with spina bifida treated with in-
termittent catheterization. Pediatr J Infect Dis
2001;20:638-9.
32. Cass AS, Luxenberg M, Gleich P, Johnson CF, Hagen
S. Clean intermittent catheterization in the manage-
ment of the neurogenic bladder in children. J Urol
1984;132:526-8.
33. Koleilat N, Sidi AA, Gonzalez R. Urethral false pas-
sage as a complication of intermittent catheterization.
J Urol 1989;142:1216-7.
Published
2016-10-10
How to Cite
1.
N E, Tambunan T, Hadinegoro SR. Profiles of patients with urinary incontinence in the Department of Child Health, Cipto Mangunkusumo Hospital. PI [Internet]. 10Oct.2016 [cited 29Mar.2024];45(2):87-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/806
Section
Articles
Received 2016-10-05
Accepted 2016-10-05
Published 2016-10-10