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Lorenger LE, Albright RA, Storm DW, Bevill MD, Reyes BA, Cooper CS. The impact of antegrade continence enemas on bladder function in patients with neurogenic bladder and bowel. J Pediatr Urol 2023; 19:625.e1-625.e6. [PMID: 37516581 DOI: 10.1016/j.jpurol.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION In neurologically intact children with constipation and lower urinary tract symptoms, treatment of constipation frequently results in improved or resolved lower urinary tract symptoms. The impact of treatment of constipation on bladder function in children with a neurogenic bowel and bladder is not well studied. The objective of this study was to evaluate the impact of antegrade continence enemas (ACE) via Chait tube on urodynamic study (UDS) parameters and urinary continence in patients with neurogenic bowel and bladder (NGB). We hypothesized that following ACE some patients would demonstrate improved UDS parameters and improved urinary continence. MATERIALS AND METHODS A review of patients with NGB who underwent a cecostomy was performed. Inclusion criteria required UDS within 12 months before and after Chait tube placement and no change in clean intermittent catheterization or anticholinergic medications. UDS parameters assessed included bladder capacity, bladder compliance, and bladder stability. In addition, the frequency of antegrade continence enemas and encopresis were reviewed as was the frequency of UTIs before and after the surgery. RESULTS 8 children met inclusion criteria, including 5 girls and 3 boys, with a mean (range) age of 8.5 years (5-13). All children were on clean intermittent catheterization and 7 were on anticholinergic medications. The patients demonstrated a significant improvement in constipation and encopresis (p < 0.05). All but 1 patient had resolution of encopresis, and 6 of 7 patients who had constipation before ACE management had a resolution of constipation. 2 patients (25%) developed urinary continence (i.e., dry between CIC), and 2 others had improvement in continence. 3, 2, and 2 patients had urodynamic improvement in bladder capacity, compliance, or stability, respectively. However, no significant improvement in urinary incontinence or UDS parameters was demonstrated for the group overall. DISCUSSION Our data demonstrate that some children with neurogenic bowel and bladder will have improvement in continence and UDS parameters following the initiation of ACE. Despite significant improvement in constipation and encopresis, the frequency of bladder improvement in this population appears less than that reported in neurologically intact children following treatment of constipation. Confirmatory studies with a larger number of children are needed. However, since constipation appears to negatively impact bladder function in some children with neurogenic bowel and bladder, it is reasonable to try to eliminate significant constipation in these patients before increasing pharmaceutical management of their neurogenic bladder.
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Affiliation(s)
- Laura E Lorenger
- Department of Urology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Ryan A Albright
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Douglas W Storm
- Department of Urology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Mark D Bevill
- Department of Urology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Bella A Reyes
- Department of Urology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Christopher S Cooper
- Department of Urology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA.
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Abstract
Somatic symptoms reflecting psychic components were recorded in connection with the Finnish National Epidemiological Study of Psychiatric Disorders. In the present work, according to the parents' concerns, frequent headache was found in 2.8%, recurrent abdominal pain in 2.4%, asthma in 0.7%, enuresis in 1.5% and soiling in 0.3% of the children. Children complaining frequently of different pains were reported in 1.0% by the teachers. Distribution by sex, population density areas and family structure are also given.
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Affiliation(s)
- S L Linna
- Department of Pediatrics, University of Oulu, Finland
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Harbauer H. [The aggressive child (author's transl)]. Monatsschr Kinderheilkd (1902) 1978; 126:472-8. [PMID: 355872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In children a "normal" aggressiveness should be distinguished from "hostile" and "inhibited" aggression; the latter usually become apparent as heteroaggressive or autoaggressive behaviour. Autoaggression is more common with younger children. Different hypotheses about the origin of aggressiveness are discussed. In the younger child nail biting, trichotillomania, rocking, an intensified phase of contrariness and enkopresis may have components of aggressiveness. In older children and adolescents dissocial forms of development, drug taking, attempted suicid, and anorexia nervosa may be parts of aggressive behaviour. Minimal brain dysfunction, autism, and postencephalitic syndromes predominate amongst organic alterations of the brain as causes for aggressive behaviour. Particularly the Lesch-Nyhan-syndrome, but equally the Cornelia de Lange-syndrome show autoaggressive tendencies.
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Hereford SM, Cleland CC, Fellner M. Territoriality and scent-marking: a study of profoundly retarded enuretics and encopretics. Am J Ment Defic 1973; 77:426-30. [PMID: 4706403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Kohler C, Carel A. [ Encopresis: dead-end or labyrinth]. Ann Med Psychol (Paris) 1971; 2:497-508. [PMID: 5147228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Achenbach TM, Lewis M. A proposed model for clinical research and its application to encopresis and enuresis. J Am Acad Child Psychiatry 1971; 10:535-54. [PMID: 5160828 DOI: 10.1016/s0002-7138(09)61755-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Fox MW. Psychopathology in man and lower animals. J Am Vet Med Assoc 1971; 159:66-77. [PMID: 4934556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Bemporad JR, Pfeifer CM, Gibbs L, Cortner RH, Bloom W. Characteristics of encopretic patients and their families. J Am Acad Child Psychiatry 1971; 10:272-92. [PMID: 5113190 DOI: 10.1016/s0002-7138(09)61737-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Launay C, Lauzanne K. [ Encopresis (retrospective survey of 45 cases)]. Rev Neuropsychiatr Infant 1970; 18:635-62. [PMID: 5480021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Vallet R, Couderc P. [Psychopathological study of a case of encopresis]. Evol Psychiatr (Paris) 1970; 35:629-37. [PMID: 5515449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Hilbun WB. Encopresis in childhood. J Ky Med Assoc 1968; 66:978-82. [PMID: 5723111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Gauthier Y, Drapeau P, Briones L, Leclaire F. [Preliminary report on a study of ego function in encopretic children]. Rev Neuropsychiatr Infant 1968; 16:727-37. [PMID: 5697586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Bigras J, Mackay J, Melvyn C, Bélair C, Trétrault L. [Pedopsychiatric diagnosis according to age and sex in a French Canadian center in Montreal]. Rev Neuropsychiatr Infant 1968; 16:739-50. [PMID: 5697587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Disorders of defaecation in children. Br Med J 1967; 3. [PMID: 6029155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Kuberski Z. [Enuresis and encopresis]. Wiad Lek 1966; 19:1067-70. [PMID: 5981878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Masson O, Perrenoud M. [ Encopresis]. Rev Med Suisse Romande 1966; 86:253-9. [PMID: 5910179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Chaptal J, Jean R, Bonnet H, Dossa D, Fontville C. [Agenesis of the sacrum: 4 cases]. Pediatrie 1965; 20:793-803. [PMID: 5843380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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PENA J, SUAREZNUNEZ MD. [SUBTOTAL AGENESIS OF THE SACRUM ASSOCIATED WITH ENURESIS AND ENCOPRESIS]. Acta Pediatr Esp 1965; 23:203-13. [PMID: 14324056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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LAUNAY C, LEROY A. [CURE OF A PSYCHOGENETIC ENCOPRESIS, SEQUELAE OF AN OPERATION FOR CONGENITAL MEGACOLON]. Arch Fr Pediatr 1964; 21:384-90. [PMID: 14139370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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Abstract
A series of ten cases of encopresis, seen in psychiatric consultation over a period of two years, is reviewed from dynamic and technical aspects. These children were found to react by regression to a traumatic separation from their mothers, over a background of maternal deprivation. A consultation approach, rather than the usual intensive psychotherapy of child and parents, was used in most of these cases, for lack of therapeutic facilities and location of family. The results have been evaluated and were found to be surprisingly better than expected. It is suggested that such an approach (psychiatric interview, social history, and interpretation to the family of specific recommendations) should be used more often before psychotherapy is attempted, thus trying to use better the emotional resources of the family. Some organic factors of this condition are discussed, as well as the role of the paediatrician in the prevention of the illness at critical stages of the child's life: namely, toilet training and birth of a sibling. The timing of the hospitalization of the child is important, and the author suggests it should not occur before the age of four. Close collaboration of the paediatrician and the child psychiatrist is most essential in such cases.
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PANDE H. [OBSTIPATION AND ENCOPRESIS IN CHILDREN. A SURVEY OF 20 PATIENTS]. Tidsskr Nor Laegeforen 1963; 83:1719-20. [PMID: 14098668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
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GALM D. [THE PSYCHOTHERAPEUTIC TREATMENT OF A NINE-YEAR OLD BOY SUBJECT TO ENCOPRESIS]. Prax Kinderpsychol Kinderpsychiatr 1963; 12:284-8. [PMID: 14112495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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SCHLANGE H. [ELECTROENCEPHALOGRAPHIC FINDINGS IN CHILD BEHAVIOR DISORDERS AND THE THERAPEUTIC CONSEQUENCES RESULTING FROM THEM]. Arch Kinderheilkd 1963; 169:123-32. [PMID: 14096404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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PUECH J, LELORD G, LALISSE P, RICHET L, TETARD A. [SEVERE MENTAL RETARDATION IN CHILDREN WITH EEG ANOMALIES. STUDY OF ELECTROCLINICAL CORRELATIONS]. Rev Neuropsychiatr Infant 1963; 11:473-502. [PMID: 14200149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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LAUNAY C. [REHABILITATION AND PSYCHOTHERAPY IN 2 CASES OF ENCOPRESIS]. Concours Med 1963; 85:4637-40. [PMID: 14050049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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SCHUNZELAAR K. Treatment of enuresis and encopresis with tofranil in chronic psychiatric female inpatients. Acta Neurol Psychiatr Belg 1963; 63:333-6. [PMID: 13987298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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CANOVA GF. [Psychogenic fecal incontinence ( encopresis) in children]. Lattante 1963; 34:213-5. [PMID: 14018341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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NIEDERMEYER K, PARNITZKE K. [Encopresis. Observations on somatic, pneumoencephalographic, electroencepphalographic and psychic findings]. Z Kinderheilkd 1963; 87:404-31. [PMID: 13938493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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KOHLER C, AIMARD P. [IS ENCOPRESIS A PSYCHOSOMATIC SYNDROME?APROPOS OF 24 CASES]. Pediatrie 1963; 18:909-33. [PMID: 14105569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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SCHIMON K. [A case of encopresis. Course of a psychagogic treatment]. Prax Kinderpsychol Kinderpsychiatr 1962; 11:130-8. [PMID: 14498424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
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RONEN R. [A case of encopresis]. Dapim Refuiim 1962; 21:139-43. [PMID: 14493675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
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CHAPMAN AH. Encopresis in childhood. Med Times 1962; 90:1-6. [PMID: 13878169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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BADER JP. [Reflections on encopresis]. Med Infant (Paris) 1960; 67:39-40. [PMID: 13685756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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ELLER H. [On encopresis in childhood]. Monatsschr Kinderheilkd (1902) 1960; 108:415-21. [PMID: 13726415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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EASSON WM. Encopresis-psychogenic soiling. Can Med Assoc J 1960; 82:624-8. [PMID: 13819105 PMCID: PMC1937925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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[ ENCOPRESIS]. Actual Pediatr (Granada) 1959; 16:501-8. [PMID: 13856535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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ANDERSEN B. [ Encopresis and psychogenic obstipation]. Ugeskr Laeger 1959; 121:1654-7. [PMID: 13793305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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MILLER RA. Value of Penthienate Methobromide in Lienteric Diarrhoea and Encopresis in Childhood. West J Med 1958; 2:1393-4. [PMID: 13596623 PMCID: PMC2027647 DOI: 10.1136/bmj.2.5109.1393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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