Daytime incontinence (DI) in a school-aged child with typical development has a substantial impact on the affected family and child's quality of life. The purpose of this descriptive retrospective case series is to add to the existing knowledge of nonpharmacological treatments for dysfunctional voiding (DV) in the pediatric population.
Participants included 4 children (median age of 8.9 ± 1.7 years) with typical development who presented to physical therapy (PT) with symptoms of DI. All participants had been successfully toilet-trained during the day for more than 2 years prior to onset of DI. All participants completed a comprehensive rehabilitation program with varying symptom severity at the start of therapy. The case series includes participants with co-occurring disorders including attention-deficit hyperactivity disorder (ADHD), anxiety, and combination ADHD and encopresis. Each child was evaluated for the frequency of DI and the parent completed a urinary symptom questionnaire pretreatment and at a 1- to 2-year follow-up (median time to follow-up: 1 year, 4 months). The frequency of DI was also recorded at the last PT treatment.
At the time of discharge, all 4 participants had resolution of DI. At the 1- to 2-year follow-up, 3 of 4 participants continued to report no DI. Participant 1 reported a return of daytime leakage of 3 times/month. All 4 participants reported improvements in perceived severity of their problem.
This retrospective case series suggests that a comprehensive PT program can positively influence a reduction in DI episodes, straining with bowel movements, and perceived severity of the child's DV condition in 4 children with differing co-morbidities.
This study was approved by the local institutional review board. A parent(s) (ie, legal guardians) and participants provided consent and assent, respectively.