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Shkalim Zemer V, Cohen HA, Richenberg Y, Gerstein M, Atias I, Gur S, Laks Y, Levinsky Y, Dvir O, Brown I, Cohen M, Ben Meir D. Personal hygiene, environmental conditions, and toilet use of children in primary schools: A cohort study. J Pediatr Urol 2023; 19:721-727. [PMID: 37357079 DOI: 10.1016/j.jpurol.2023.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/07/2023] [Accepted: 06/06/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Many primary school children withhold urine and stool whilst at school for various reasons. Limited toilet access and the failure to provide safe, sanitary toilets are putting children at risk for toilet avoidance behavior. OBJECTIVE We aimed to examine personal hygiene, environmental conditions, the perception of these on children, and their toilet use in primary schools. STUDY DESIGN Children aged 6-12 and their parents were asked to complete a self-report questionnaire regarding toilet behavior and the perception of school toilet standards. RESULTS The main findings are listed below using the data from the questionnaire. DISCUSSION We found that 9% and 63% of the children avoided urination and defecating at school, respectively. Similar results were reported previously. The participants' perceptions regarding the environmental conditions of school toilets and conditions revealed that 34% of the children felt that the toilets were dirty or very dirty. Around one-third of them reported a lack of toilet paper sometimes or most of the time. These unsatisfying hygienic conditions of school toilets can be easily solved. Unfortunately, 46% of the children in our study experienced bullying in school toilets. These worrisome data are seldom reported in other studies. The urination habits of the girls, who mostly preferred to partially squat or stand may lead to dysfunctional voiding and incomplete bladder emptying. Our study was limited by the relatively small population, the subjectiveness of the self-reporting questionnaire, and the voiding and defecation habits of the investigated children during school hours. These hours do not necessarily reflect the children's habits after school hours and during the weekends. Despite these limitations, the discussed issues regarding personal hygiene and the environmental conditions in the sampled primary schools are extremely important. CONCLUSION Nearly half of the school children had negative perceptions of school toilets. This should raise awareness and concern for school staff to consider and investigate potential facilities improvement in light of the impact observed here. Implementation of appropriate education and a better environment of toilet facilities and security is important for the children's well-being.
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Affiliation(s)
- Vered Shkalim Zemer
- Clalit Health Services, Dan-Petach-Tikva District, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel.
| | - Herman Avner Cohen
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Ambulatory Community Clinic, Petach Tikva, Israel.
| | | | - Maya Gerstein
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Ambulatory Community Clinic, Petach Tikva, Israel.
| | - Ifat Atias
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Neve Gan Clinic, Petach Tikva 4926040, Israel.
| | - Shmuel Gur
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Ambulatory Community Clinic, Kfar Saba 4422941, Israel.
| | - Yoseph Laks
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Ambulatory Community Clinic, Ramat Aviv, Tel Aviv 6905234, Israel.
| | - Yoel Levinsky
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
| | - Or Dvir
- Pediatric Urology Unit, Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
| | - Iris Brown
- Pediatric Urology Unit, Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
| | - Moriya Cohen
- Microbiology Unit, Ariel University, Ariel 98603, Israel.
| | - David Ben Meir
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Urology Unit, Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
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Peng CH, Chen SF, Kuo HC. Long-Term Follow-Up of Lower Urinary Tract Outcome in Children with Dysfunctional Voiding. J Clin Med 2022; 11:jcm11247395. [PMID: 36556011 PMCID: PMC9781924 DOI: 10.3390/jcm11247395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/18/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Objective: To investigate the long-term clinical and urodynamic outcomes of a small cohort of children who received short-term urotherapy for confirmed dysfunctional voiding (DV) and lower urinary tract symptoms (LUTS). Materials and Methods: This study included 26 children with confirmed LUTS and DV via video urodynamic study (VUDS) and received standard urological therapy, pelvic floor muscle training, or surgical intervention in childhood. Their current lower urinary tract conditions were assessed by chart review and direct and telephone interviews. Charts of 14 patients who underwent follow-up VUDS were reviewed to investigate their bladder and voiding dysfunction or follow-up on previous treatment results. The satisfaction of lower urinary tract status was assessed using the global response assessment (GRA) scale. Results: At initial enrolment, the mean age was 9.54 ± 3.88 years, and urological treatment was performed during the first 1−5 years thereafter. Most patients were not regularly followed in the urology clinic. Among the 14 children available for follow-up, a GRA score of 3 was reported by 10 (71.4%) after a mean follow-up period of 10.3 ± 6.74 (range, 2−20) years, indicating satisfactory bladder and voiding conditions. Four children with less favorable outcomes (GRA score of <3) had significantly more post-void residual urine volume at baseline, and 75% of these patients had central nervous system diseases. Daytime incontinence and enuresis rates were significantly decreased at follow-up compared with the baseline. Significantly increased bladder capacity and sensation and significantly decreased voiding detrusor pressure were found on follow-up VUDS. Conclusions: Children with DV who received standard urotherapy upon diagnosis exhibited improved LUTS at a 10-year follow-up. Of the 14 children available for follow-up, 10 (71.4%) reported satisfactory bladder and voiding status without further medication or urotherapy, with significantly decreased voiding detrusor pressure.
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Affiliation(s)
- Chung-Hsin Peng
- Department of Urology, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan
| | - Sheng-Fu Chen
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970473, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970473, Taiwan
- Correspondence: ; Tel.: +886-3-8561825 (ext. 2117); Fax: +886-3-8560794
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Casal-Beloy I, Capdevila-Vilaró B, Pérez-Bertólez S, Martín-Solé O, García González M, Tarrado Castellarnau X, García-Aparicio L. Comentary on "Comparison and characteristics of children successfully treated for daytime urinary incontinence". J Pediatr Urol 2022; 18:247-248. [PMID: 35153147 DOI: 10.1016/j.jpurol.2021.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Isabel Casal-Beloy
- Pediatric Urology Unit, Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues Del Llobregat, Barcelona, 08950, Spain; Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues Del Llobregat, Barcelona, 08950, Spain.
| | - Blanca Capdevila-Vilaró
- Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues Del Llobregat, Barcelona, 08950, Spain.
| | - Sonia Pérez-Bertólez
- Pediatric Urology Unit, Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues Del Llobregat, Barcelona, 08950, Spain; Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues Del Llobregat, Barcelona, 08950, Spain.
| | - Oriol Martín-Solé
- Pediatric Urology Unit, Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues Del Llobregat, Barcelona, 08950, Spain; Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues Del Llobregat, Barcelona, 08950, Spain.
| | - Miriam García González
- Pediatric Urology Division, Pediatric Surgery Department, University Children´s Hospital of A Coruña, As Xubias, 84, CP: 15006, A Coruña, Spain.
| | - Xavier Tarrado Castellarnau
- Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues Del Llobregat, Barcelona, 08950, Spain.
| | - Luís García-Aparicio
- Pediatric Urology Unit, Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues Del Llobregat, Barcelona, 08950, Spain; Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues Del Llobregat, Barcelona, 08950, Spain.
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