Standard urotherapy as first-line intervention for daytime incontinence: a meta-analysis.

According to the International Children’s Continence Society (ICCS) guidelines for the treatment of daytime urinary incontinence (DUI) in children and adolescents, the first-line intervention for all types of DUI is standard urotherapy (SU). Despite this recommendation there is still no meta-analysi...

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Publicado en:European Child & Adolescent Psychiatry Vol. 27; no. 8; pp. 949 - 965
Autores principales: Schäfer, S. K., Niemczyk, J., von Gontard, A., Pospeschill, M., Becker, N., Equit, M.
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Springer Nature Aug2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2018
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00787-017-1051-6
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        atl: Standard urotherapy as first-line intervention for daytime incontinence: a meta-analysis.
      aug:
        au:
          Schäfer, S. K.
          Niemczyk, J.
          von Gontard, A.
          Pospeschill, M.
          Becker, N.
          Equit, M.
        affil: Department of Psychology, Saarland University, Building A 1.3, 66123, Saarbrücken, Germany
      sug:
        subj:
          Urinary Incontinence Therapy
          Meta Analysis
          Human
          Odds Ratio
          Disease Remission
          Child
          Adolescence
          Effect Size
          Treatment Outcomes
          Systematic Review
          Child: 6-12 years
          Adolescent: 13-18 years
      ab: According to the International Children’s Continence Society (ICCS) guidelines for the treatment of daytime urinary incontinence (DUI) in children and adolescents, the first-line intervention for all types of DUI is standard urotherapy (SU). Despite this recommendation there is still no meta-analysis available on the effectiveness of SU. The aim of this study is to provide a meta-analytic evaluation of the intervention. This meta-analysis is based on Odds Ratios (OR) and consists of 26 patient samples out of 19 studies (N = 1609), collected from well-established medical databases. Remission rates after SU are compared to spontaneous remission rates, which are matched to the individual follow-up period. The meta-analysis shows that SU is an effective treatment of DUI. Compared to a spontaneous remission rate of 15.40% per year, urotherapy increases the probability to recover by a factor of 7.27 (6.57 if corrected for publication bias). After exclusion of three outlying samples this effect can be generalized for all types of SU and all patient populations. Moderator analyses cannot identify variables which significantly influence the variance of effect sizes. However, RCTs seem to be associated with lower effects, even when the control group is not considered for effect size calculation. Based on the present meta-analysis, SU is an effective intervention for treating DUI in children and adolescents. Of 100 patients in 1 year, approximately 56 patients (54 if corrected for publication bias) remit after being treated with SU, while only 15 out of 100 remit spontaneously. However, to further quantify the effect size of SU in comparison to spontaneous remission rates and other treatments, additional RCTs are still needed.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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