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Kostekci YE, Baskan S, Topcu S, Kose SK, Ozgur EG, Orhon F. Evaluation of the effects of the toilet training process on the children's quality of life. Pediatr Int 2023; 65:e15508. [PMID: 36799016 DOI: 10.1111/ped.15508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 02/02/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Toilet training is a significant developmental milestone for children. During the process of toilet training, voiding and defecation problems may develop, which have a major adverse impact on the child's quality of life (QoL). The aim of this study was to assess voiding and defecation problems in the process of toilet training and evaluate how these issues influenced the children's QoL. METHODS The children included in the study were followed up at the Department of Social Pediatrics, Ankara University School of Medicine. Participants were surveyed via a questionnaire that included sociodemographic features, the toilet training process, and the Pediatric Quality of Life Inventory. RESULTS The study included 177 children and their parents. There was no correlation between the parents' age, sociodemographic features, or the timing of the start of toilet training. Voiding problems were found in 55.6% and defecation problems in 23.6% of the children included in the study. Urinary retention during play and nocturnal enuresis were more frequent in the children toilet trained at 25-36 months of age. The self-reported QoL scores in children with voiding problems and with both voiding and defecation problems were lower than those in children did not have any problems. CONCLUSIONS Even if a child has been toilet trained, it is essential to investigate daily urination and defecation habits at every follow-up visit and to discuss with families when a physician should be consulted.
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Affiliation(s)
| | - Sevgi Baskan
- Division of Social Pediatrics, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Seda Topcu
- Division of Social Pediatrics, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Serdal Kenan Kose
- Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emrah Gokay Ozgur
- Department of Biostatistics, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Filiz Orhon
- Division of Social Pediatrics, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
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Carvalho TA, Vasconcelos MMDA, de Bessa J, Bastos JM, Dutra MF, Guimarães ICDO, Lima EM, Silva ACSE, Mrad FCDC. Relationship between primary monosymptomatic enuresis and process toilet training: a case-control. Int Braz J Urol 2022; 48:944-951. [PMID: 36173406 PMCID: PMC9747032 DOI: 10.1590/s1677-5538.ibju.2022.0381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/05/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Primary monosymptomatic nocturnal enuresis (PMNE) is a prevalent condition in childhood, and the pathophysiology is multifactorial. This study investigated the relationship between the toilet training process (TT) and PMNE in children and adolescents. PATIENTS AND METHODS A case-control study was carried out from 2015 to 2020. The presence of PMNE was identified according to International Children's Continence Society criteria. A semi-structured questionnaire was applied to assess TT. RESULTS The study included 103 children and adolescents with PMNE and 269 participants with normal psychomotor development without PMNE (control group [CG]). Readiness signals were more remembered and less frequent in participants with PMNE (p=0.001) when compared to control group. No differences were found between the groups regarding the onset age of the daytime TT (p= 0.10), the nocturnal TT (p=0.08), the acquisition of daytime continence (p=0.06), and the type of equipment used for the TT (p=0.99). The use of Child-Oriented approach in group of children with enuresis was lower than in controls [87.4% (90/103) versus 94% (250/266)], respectively (OR= 0.44, 95% CI 0.21-0.94, p = 0.039). CONCLUSIONS The age of onset of TT, acquisition of daytime continence, and the type of equipment were not associated with higher occurrence of PMNE. On the other hand, the Child-Oriented approach was a protective factor for the occurrence of PMNE.
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Affiliation(s)
- Tânia Antunes Carvalho
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Mônica Maria de Almeida Vasconcelos
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - José de Bessa
- Universidade Estadual de Feira de SantanaDepartamento de UrologiaFeira de SantanaBABrasilDepartamento de Urologia, Universidade Estadual de Feira de Santana (UFFS), Feira de Santana, BA, Brasil
| | - José Murillo Bastos
- Universidade Federal de Juiz de ForaFaculdade de MedicinaDepartamento de UrologiaJuiz de ForaMGBrasilDepartamento de Urologia, Faculdade de Medicina, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brasil,Faculdade de Ciências Médicas de Juiz de ForaMaternidade Therezinha de JesusDepartamento de UrologiaJuiz de ForaMGBrasilDepartamento de Urologia, Maternidade Therezinha de Jesus, Faculdade de Ciências Médicas de Juiz de Fora, Juiz de Fora, MG, Brasil
| | - Melissa Faria Dutra
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Isabela Cristina de Oliveira Guimarães
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Eleonora Moreira Lima
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Ana Cristina Simões e Silva
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil,Universidade Federal de Minas GeraisLaboratório Interdisciplinar de Investigação MédicaBelo HorizonteMGBrasilLaboratório Interdisciplinar de Investigação Médica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Flávia Cristina de Carvalho Mrad
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil,Correspondence address: Flávia Cristina de Carvalho Mrad, MD Depart. de Pediatria, Unidade de Nefrologia Pediátrica, Fac. de Med., Univ. Federal de Minas Gerais (UFMG) Avenida Alfredo Balena 190. sala 267, Santa Efigênia Belo Horizonte, MG, 30130-100, Brasil E-mail:
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de Carvalho Mrad FC, da Silva ME, Moreira Lima E, Bessa AL, de Bessa Junior J, Netto JMB, de Almeida Vasconcelos MM. Toilet training methods in children with normal neuropsychomotor development: A systematic review. J Pediatr Urol 2021; 17:635-643. [PMID: 34090792 DOI: 10.1016/j.jpurol.2021.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Toilet training (TT) is an important milestone in child development. The purpose of this review is to summarize the different TT methods found in the literature and determine their effectiveness for the TT process. DATA SOURCES Articles about toilet training were collected from databases, including PubMed and Scopus. The Preferred Reporting Items for Systematic Reviews (PRISMA) statement was used to guide the systematic review. RESULTS Two main classifications were used: a child-oriented approach and a structured behavioral approach. Most children were trained by the structured behavioral approach, with early onset, but at the age of completion of TT, similar to those who used a child-oriented approach. Success rates, in the few studies that reported, were better with the child-oriented approach. The lowest reported success rate was the daytime humidity alarm approach. There is no consensus on the best method to be used, as it involves a wide variety of parents' preferences and expectations and cultural differences, with studies showing great heterogeneity and methodological flaws that make meta-analysis unfeasible. CONCLUSIONS The approaches have not been directly compared, so it isn't possible to make definitive claims about one method's superiority over the other.
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Affiliation(s)
- Flávia Cristina de Carvalho Mrad
- Universidade Federal de Minas Gerais, School of Medicine, Pediatrics Departament, Neprology Unit, Avenida Alfredo Balena 190. sala 267, Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil.
| | - Maria Eduarda da Silva
- Universidade Federal de Minas Gerais, School of Medicine, Pediatrics Departament, Neprology Unit, Avenida Alfredo Balena 190. sala 267, Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Eleonora Moreira Lima
- Universidade Federal de Minas Gerais, School of Medicine, Pediatrics Departament, Neprology Unit, Avenida Alfredo Balena 190. sala 267, Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Ana Luiza Bessa
- Universidade Federal de Minas Gerais, School of Medicine, Pediatrics Departament, Neprology Unit, Avenida Alfredo Balena 190. sala 267, Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - José de Bessa Junior
- Universidade Estadual de Feira de Santana, Urology Departament, avenida transnordestina s/n, Feira de Santana, Bahia, 44036-900, Brazil
| | - José Murillo Bastos Netto
- Universidade Federal de Juiz de Fora, School of Medicine, Urology Department, Av. Eugênio do Nascimento s/n Dom Bosco, Juiz de Fora, MG, 36038-330, Brazil; Faculdade de Ciências Médicas e da Saúde de Juiz de Fora e Maternidade Therezinha de Jesus, Urology Department, R. Dr. Dirceu de Andrade, 33 - São Mateus, Juiz de Fora, MG, 36025-330, Brazil
| | - Mônica Maria de Almeida Vasconcelos
- Universidade Federal de Minas Gerais, School of Medicine, Pediatrics Departament, Neprology Unit, Avenida Alfredo Balena 190. sala 267, Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
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Favorito LA. A decisive year to International Brazilian Journal of Urology. Int Braz J Urol 2020; 47:1-3. [PMID: 33047907 PMCID: PMC7712705 DOI: 10.1590/s1677-5538.ibju.2021.01.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Luciano A Favorito
- Unidade de Pesquisa Urogenital - Universidade Estadual do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil.,Serviço de Urologia, Hospital Federal da Lagoa, Rio de Janeiro, RJ, Brasil
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