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Background: Nocturnal enuresis is generally considered a children's condition, yet it may persist 1%–2% in adolescence and early adulthood. Refractory patients often demand follow‐up by multidisciplinary teams, which is only restricted to some of the expert tertiary centers. However, there are no standardized transition programs/guidelines when follow‐up must be passed from pediatric to adult healthcare providers. Aim, Materials & Methods: To investigate this issue, we conducted a literature search on enuresis transition, which resulted in no articles. We, therefore, proceeded in a rescue search strategy: we explored papers on transition programs of conditions that may be related and/or complicated by enuresis, nocturia, or other urinary symptoms (chronic diseases, CKD, bladder dysfunction, kidney transplant, neurogenic bladder). Results: These programs emphasize the need for a multidisciplinary approach, a transition coordinator, and the importance of patient and parent participation, practices that could be adopted in enuresis. The lack of continuity in enuresis follow‐up was highlighted when we investigated who was conducting research and publishing on enuresis and nocturia. Pediatric disciplines (50%) are mostly involved in children's studies, and urologists in the adult ones (37%). Discussion: We propose a stepwise approach for the transition of children with enuresis from pediatric to adult care, depending on the clinical subtype: from refractory patients who demand more complex, multidisciplinary care and would benefit from a transition coordinator up to children/young adults cured of enuresis but who persist in having or present lower urinary tract symptoms (LUTS)/nocturia later on. In any case, the transition process should be initiated early at the age of 12–14 years, with adequate information to the patient and parents regarding relapses or LUTS/nocturia occurrence and of the future treating general practitioner on the enuresis characteristics and comorbidities of the patient. [ABSTRACT FROM AUTHOR]

Aims: To investigate if the standard protocol for uroflowmetry, recommended by the International Children's Continence Society, remains accurate when integrating EMG measurement by means of superficial electrodes. Methods: A cross‐sectional study was conducted including healthy children. Group A performed two direct repetitions of uroflowmetry in combination with electromyography (uroflow/EMG). Group B performed a preceding measurement of isolated uroflowmetry, followed by two randomized measurements of uroflowmetry with and without EMG. Interpretation of uroflow curve was assessor blinded by a pediatric urologist and secondly performed using the flow index methodology. Statistical analysis compared different voids within each group and between group A and B. Results: Eighty‐three children were included and 206 uroflow measurements were obtained. In both groups statistical findings confirmed the hypothesis that it is preferable to perform an additional measurement before the use of uroflow/EMG. Although both groups showed improvement between voids, the group with initial uroflow measurement followed by uroflow/EMG measurement showed more improvement in concern of curve pattern. An initially better first void in group A, but no statistical difference between the second void in group A and uroflow/EMG testing in group B further demonstrates a higher improvement in group B. This suggests the use of a precedent uroflowmetry without EMG is preferable to immediate testing with EMG. Conclusions: It should be mandatory to perform one measurement in advance to ensure the reliability of the results. It is suggested to initiate the procedure with a single uroflowmetry measurement followed by one measurement of uroflow with EMG testing. [ABSTRACT FROM AUTHOR]

Aims To systematically review the scientific literature addressing lower urinary tract symptoms (LUTS) and urodynamic findings in adults and children with Cerebral Palsy (CP). Prognostic factors were also investigated. Methods A systematic research was conducted on the electronic databases PubMed, Web of Science, and CINAHL. Only full text clinical trials which examined the prevalence of LUTS or urodynamic findings in children or adults with CP were eligible. LUTS and urodynamic findings, defined by the International Children's Continence Society, were extracted from the included studies. Pooled average of extracted data was calculated. Studies were scored on methodological and reporting quality using the Dutch Cochrane Checklist, EBRO guidelines, and the Strengthening the Reporting of Observational Studies in Epidemiology Statement (STROBE) checklist. Results Twenty-seven studies fulfilled selection criteria. Methodological and reporting quality were moderate to low. An average of 55.5% of subjects with CP experience one or more LUTS. Storage symptoms are more common than voiding symptoms due to the high prevalence of neurogenic detrusor overactivity. Patients with voiding symptoms and pelvic floor overactivity are more prone to progress to upper urinary tract dysfunction in adult life. Urodynamic evaluation can direct management. Negative prognostic factors are the spastic subtype with quadriplegic distribution, moderate to severe functional impairment (GMFCS III or higher) and severe cognitive impairment. Conclusion The significant prevalence of LUTS, risk for deterioration, and the impact of urinary tract symptoms on quality of life and health status warrants the need for evaluation and treatment in further research. Neurourol. Urodynam. 36:541-549, 2017. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Purpose This article is a standardization document of the International Children's Continence Society (ICCS); it represent a consensus of ICCS on the management of pediatric daytime urine incontinence (DUI). Materials and Methods This document was designed and written by a multi-disciplinary core group of authors appointed by the ICCS' board. Results Based on evidence of studies and the experience of experts, the treatment guideline of DUI is assembled in this standardization document. Guidelines and the algorithm of management include non-pharmacological treatment (urotherapy), as well as the pharmacological therapy and other modalities that are presented for DUI in general, as along with recommendations for individual conditions. Conclusion The final document is not a systematic literature review. It includes relevant research when available as well as experts' opinion on the current understanding of daytime incontinence in children. This document illustrates that specific treatment of DUI based on an exact diagnosis is effective. The mainstay of treatment is urotherapy, but a combination of treatment modalities is often necessary. Neurourol. Urodynam. 36:43-50, 2017. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]