Abstract

Assessing Health-related Benefit after Reconstruction for Urinary and Fecal Incontinence in Children: A Parental Perspective

Strine AC1, Misseri R2, Szymanski KM2, Kaefer M2, Rhee AC2, Hillier K2, Rink RC2, Cain MP2. J Urol. 2015 Jan 3. pii: S0022-5347(14)05217-3. doi: 10.1016/j.juro.2014.12.089. [Epub ahead of print]
 
     
Author information

1Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, Indiana 46202, USA. Electronic address: astrine@iupui.edu. 2Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, Indiana 46202, USA.

Abstract

PURPOSE: We sought to evaluate HRB in children undergoing reconstruction for urinary and fecal incontinence from a parental perspective.

MATERIALS AND METHODS: A HRB instrument was mailed to the parents or guardians of 300 consecutive patients who previously underwent reconstruction for urinary and/or fecal incontinence at our institution between 1997-2011. We assessed parent-reported HRB using the validated GCBI and their satisfaction with 6 supplemental questions. One-sample t-tests as well as exploratory univariate and multivariate linear regressions were performed for statistical analysis.

RESULTS: The response rate was 40.0% at a mean elapsed time of 5.5 years (0.6 - 13.8 years) after reconstruction. SB was the most common primary diagnosis in 48 patients (56.5%). The mean total GCBI score and subscores for each domain were positive, indicating an improved HRB after reconstruction (all p<0.0001). Certain patients, possibly based on diagnosis and gender, may particularly benefit from reconstruction (p≤0.04). Parents believed that the bladder augmentation and/or urinary continent catheterizable channel most changes their child's life but that the achievement of stool continence was most important to themselves. Only 17 families (16.2%) required more than 1 month to become comfortable with catheterizations, and 69 patients (68.8%) required less care or no assistance with daily activities after reconstruction. Only 2 parents (1.9%) would be unwilling to consent to the procedure again.

CONCLUSIONS: In patients who participated in our study, we observed moderate parental satisfaction and a parent-reported improvement in HRB for children undergoing reconstruction for urinary and incontinence.

© Copyright 2013-2017 GI Health Foundation. All rights reserved.
This site is maintained as an educational resource for US healthcare providers only. Use of this website is governed by the GIHF terms of use and privacy statement.