Biomedical subjects

C Renson

Publications and source records attributed to C Renson.

4 recordsLinked to original sources

PubMed1998

Pelvic-floor therapy in girls with recurrent urinary tract infections and dysfunctional voiding.

OBJECTIVE: To analyse the treatment of girls with recurrent urinary tract infections (UTIs, at least two periods confirmed) and urodynamically confirmed dysfunctional voiding with pelvic-floor therapy. PATIENTS AND METHODS: Forty-two girls with recurrent UTIs were treated prospectively during a study period of 18 months. Training consisted of an individually adapted voiding and drinking schedule, pelvic-floor relaxation biofeedback, instructions on toilet behaviour and biofeedback uroflowmetry; residual urine was estimated by ultrasonography. All the girls received prophylactic antibiotics during treatment and those girls with urodynamically proven detrusor instability (33) received anticholinergics. Therapy was considered successful when the girls remained free of infection with no further prophylactic antibiotics for at least 6 months. RESULTS: Four girls younger than 6 years all suffered nocturnal and diurnal incontinence and two had reflux. Treatment was effective for recurrent UTI in all and the reflux resolved in two. All four girls became dry during the day and one became dry at night. In the 38 girls older than 6 years, the treatment was successful for recurrent UTI in 24 from the out-patient and in all three from the clinical programme. Reflux, which was seen in six of these girls, resolved in five; one girl underwent bilateral reimplantation. Incontinence was treated in all 23 girls with incontinence problems before treatment (four of whom were initially dry). Twelve girls needed a wetting alarm to become dry during the night. In four girls the treatment was effective for recurrent UTI but the incontinence persisted; in seven the treatment was considered unsuccessful as they all had UTIs after treatment; all remained incontinent. Reflux persisted in all four girls in this group who had reflux before treatment. CONCLUSION: The training programme was effective in treating recurrent UTI in 35 of 42 girls (83%). The persistence of incontinence problems is a bad prognostic factor for the recurrence of UTI after the training programme. Pelvic-floor therapy seems a reasonable and meaningful component in the treatment of recurrent UTIs in which detrusor-sphincter dyssynergia plays a role.

Adolescent↗

PubMed1996

Outpatient pelvic-floor therapy in girls with daytime incontinence and dysfunctional voiding.

OBJECTIVES: Analysis of an experience in treating girls with dysfunctional voiding with an outpatient pelvic-floor therapy consisting of voiding and drinking schedule, pelvic-floor relaxation biofeedback, instructions on toilet behavior, and uroflowmetry. METHODS: The files of 50 girls (between 6 and 13 years of age) with urodynamically proven dysfunctional voiding who participated in the training program were analyzed retrospectively. Thirty-five girls received anticholinergics during the entire course of the training. The long-term absence of diurnal incontinence was used as the criterion for the success of the therapy. The duration of treatment before reaching this success was used as a parameter to measure the intensity of therapy. For a portion of the study group, a comparison is made with the duration of the preceding therapies to demonstrate indirectly the cumulative effect of the pelvic-floor therapy. RESULTS: Forty-six girls (92%) normalized their flow and bladder capacity after therapy and saw their daytime incontinence disappearing. All of these girls achieved this result in a maximum of 18 sessions within a 6-month period. At the follow-up examination after 6 months, five of the girls had relapsed (10%), which brings the ultimate success after 6 months of follow-up to 82%. CONCLUSIONS: Pelvic-floor therapy seems to be a reasonable and meaningful component in the treatment of bladder dysfunction in which detrusor-sphincter dyscoordination plays a role.

Adolescent↗

PubMed1995

Commercial television bladder dysfunction.

Bladderdysfunction seems to have an increasing frequency in infancy, and especially in children without obvious congenital organic or functional bladderdysfunction. The disorder seems is related with changes in our behaviour, that are stimulated by familial and social pseudo-reasons. Commercial interests and marketing play a major role. This leads to wrong dry-training, an exaggerated hygienic education, prudisheness, wrong toilet-posture, lack of time to void, post-poning, wrong drink- and void-pattern, wrong food-pattern and increasing constipation. Prevention is necessary by an adapted reeducation of parents ans society.

Adolescent↗

PubMed1995

Bladder function and non-neurogenic dysfunction in children: classification and terminology.

Urological function and dysfunction in children are different from function and dysfunction in adults. The dynamics of the urinary tract in children are more complex as development from simple reflex controlled infant bladder to mature bladder function takes place during the first five years of live. The most crucial event in this development is the maturation of the inhibition that takes place in the growing urinary tract. Apart from gaining neurological control over de lower urinary tract there is the physical growth of the bladder-sfincter unit. Otherwise in children there exist a large amount of structural organic congenital pathology of the lower urinary tract that can trouble the normal development. Finally there is the cognitive function that has no anatomical substrate in the lower urinary tract but which takes place in the central nervous system and which is influenced by training and which can play a major role in development of non structural functional dysfunction. In order to train a child adequately the anatomical structure needs to have undergone enough maturation. By training a child on a too early age one can help to develop non structural functional dysfunction. In a time where competition in dry-training is encouraged by commercial pressure and where parents have less time, so that they are urged to train their children dry, more and more non-structural functional dysfunction in children is seen. The most prominent symptom of maldevelopment of the urinary tract, be it structural or functional is urinary incontinence. It is the most common problem seen in the paediatric urology practice.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗