School nurse perceptions and knowledge of pediatric toileting.

Objective: We surveyed school nurses on toileting conditions in schools, their level of understanding related to normal toileting patterns in school-age children, and whether they are in need of additional resources to promote healthy toilet habits for their students.

Materials And Methods: An Institutional Review Board approved web-based survey with 34 questions was employed; 562 nurses completed the survey and 97% were currently employed as school nurses. Participants were invited via email blasts through national school nursing associations and the Iowa Department of Education.

Efficacy of transcutaneous electrical nerve stimulation in children with overactive bladder refractory to pharmacotherapy.

Objectives: To examine the outcome of transcutaneous electrical nerve stimulation (TENS) use in children with overactive bladder refractory to behavioral and anticholinergic therapy.

Methods: We reviewed the data of 18 children (13 girls and 5 boys; mean age 9 years) with overactive bladder refractory to standard therapy who underwent at-home TENS treatment twice daily for 20 minutes. Symptoms and objective measures (noninvasive uroflowmetry and postvoid residual urine volume) were noted at baseline and after treatment.

Evaluation of constipation by abdominal radiographs correlated with treatment outcome in children with dysfunctional elimination.

Objectives: To analyze the utility of assessing degree of constipation by abdominal radiograph (KUB) in relation to symptoms and urodynamic data in children with dysfunctional elimination.

Methods: A retrospective review of children with concomitant constipation and daytime incontinence was performed. Inclusion required at least two consecutive visits with KUB and noninvasive uroflowmetry.

Initial trial of timed voiding is warranted for all children with daytime incontinence.

Objectives: To analyze the relationship between potential prognostic factors and early success after treatment of childhood daytime urinary incontinence without anticholinergic medication.

Methods: A total of 63 patients with daytime urinary incontinence met the inclusion criteria for a retrospective review of the effect of a timed voiding regimen. The severity, duration, and frequency of wetting, along with age, sex, and uroflow parameters, were recorded.

Frequency of wetting is predictive of response to anticholinergic treatment in children with overactive bladder.

Objectives: To examine the variables relative to the response of oxybutynin treatment in children with daytime urinary incontinence.

Methods: The records of patients seen for voiding problems between 1999 and 2003 were reviewed. Patients taking oxybutynin for 3 months or longer were included in the study.

Teachers' knowledge of normal and abnormal elimination patterns in elementary school children.

Dysfunctional elimination may be learned, to some degree. Because children spend nearly half of their waking hours at school, there is the potential for school to have a significant impact on their elimination patterns. Surveys were mailed to 1,000 randomly selected Iowa public elementary school teachers; 467 of the surveys were returned.

Improved uroflow parameters and post-void residual following biofeedback therapy in pediatric patients with dysfunctional voiding does not correspond to outcome.

Purpose: We evaluated pediatric patients who were treated with biofeedback for dysfunctional voiding with respect to clinical outcome and objective changes in uroflow parameters and post-void residual.

Materials And Methods: We retrospectively reviewed 81 patients treated for dysfunctional voiding and/or urinary tract infections with biofeedback. Conservative management had previously failed in all patients.

Polyethylene glycol 3350 for constipation in children with dysfunctional elimination.

Purpose: Children with daytime wetting often have constipation, and treatment of constipation helps children become dry. Polyethylene glycol 3350 (Miralax, Braintree Laboratories, Braintree, Massachusetts) is a nonaddictive, tasteless powder that can be mixed with any liquid for treatment of constipation.

Materials And Methods: We review our use of polyethylene glycol 3350 in 35 girls and 11 boys with dysfunctional elimination.

Do public schools teach voiding dysfunction? Results of an elementary school teacher survey.

Purpose: Dysfunctional voiding in children may partly be learned, and constitutes a significant percentage of pediatric urological referrals. Half of a child's waking hours are spent at school, suggesting a significant potential impact on learned toileting behaviors. Nonetheless, data on teacher perception and practice regarding pediatric voiding are lacking.

Variability in catheter microwave sterilization techniques in a single clinic population.

Purpose: We designed a survey to assess the microwave sterilization technique practiced by patients at our clinic who perform clean intermittent catheterization.

Materials And Methods: A 23-question survey addressing urinary catheter use and home sterilization techniques was mailed to 129 patients. A followup survey was mailed to 47 respondents who reported using a microwave oven to sterilize the catheters to assess the microwave technique further.