Preoperative occupational therapy in children with neurogenic bladder: improving independence with bladder management and self-catheterization.

Purpose of review: The purpose of this review is to (1) summarize the current literature on the use of occupational therapy services to facilitate self-catheterization and self-management skills in pediatric patients with neurogenic bladder, and (2) propose how occupational therapists can partner with urologists to improve surgical decision-making for lower urinary tract reconstruction, specifically the implementation of continent catheterizable channels in pediatric populations. Topics include occupational therapy, self-catheterization training, toileting independence, lower urinary tract reconstruction, continent catheterizable stoma, and urinary incontinence. Recent findings: Recent evidence indicates the use of occupational therapists to train pediatric patients with neurogenic bladder on self-catheterization is beneficial, and can lead to more efficient outcomes. There is a lack of literature detailing the frequency and duration, of occupational therapy treatment for needed toileting independence. There is also a lack of literature on standardization of surgical indications for a continent catheterizable channel. No available studies describe methods that exhaust or standardize urethral self-catheterization training prior to surgical intervention for increased independence. There is limited data on predictive factors and recommended timelines to initiate self-catheterization. No studies have explored occupational therapy evaluations as part of pre-operative assessment for independent bladder management via catheterizable channels. Summary: Emerging evidence supports and promotes the collaboration of occupational therapists and healthcare providers to enhance the management of neurogenic bladder and self-catheterization. Further studies are needed to evaluate the use of occupational therapists in urologic practice, with the aim of prioritizing independence and quality of life. [ABSTRACT FROM AUTHOR]