MP50-18 NOVEL USE OF AN ENURESIS ALARM TO GUIDE TIMING OF BLADDER EMPTYING ASSESSMENT IN COMPLEX NON-VERBAL CHILDREN

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You have accessJournal of UrologyPediatrics III (MP50)1 May 2024MP50-18 NOVEL USE OF AN ENURESIS ALARM TO GUIDE TIMING OF BLADDER EMPTYING ASSESSMENT IN COMPLEX NON-VERBAL CHILDREN Peter Y. Cai, Andrea Balthazar, Regina L. Tham, Badar Omar, Sangeeta Mauskar, Walter Wickremasinghe, Bartley G. Cilento, and Caleb P. Nelson Peter Y. CaiPeter Y. Cai , Andrea BalthazarAndrea Balthazar , Regina L. ThamRegina L. Tham , Badar OmarBadar Omar , Sangeeta MauskarSangeeta Mauskar , Walter WickremasingheWalter Wickremasinghe , Bartley G. CilentoBartley G. Cilento , and Caleb P. NelsonCaleb P. Nelson View All Author Informationhttps://doi.org/10.1097/01.JU.0001008684.57262.97.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bladder emptying is often impaired in non-verbal children with medical complexity, but assessment is challenging due to the lack of indication that voiding has occurred. We sought to test the feasibility and efficacy of an enuresis alarm to guide timing of post-void residual (PVR) measurement in these patients. METHODS: We prospectively enrolled 15 complex patients (<21 years old, nonverbal, diaper-voiding) hospitalized July-September 2023. Exclusion criteria were urinary tract infection or indwelling catheter. Protocol included a 4-hour period with alarm in place (PVR assessment after alarm trigger), and a 4-hour period of routine care (PVR assessment based on nurse observation of wet diaper). PVR was measured with an ultrasound bladder scanner. The primary endpoint was PVR volume with or without alarm. Secondary endpoint was number of detected voids. RESULTS: Median age was 10 years (range 0.8 to 16) and median weight was 20.7 kg (range 6.8 to 49.6). The most common diagnoses were cerebral palsy (n=7), spastic quadriplegia (n=5), and epilepsy (n=7). Four patients were not included in data analysis due to not having at least one void in both the alarm and routine study periods for comparison. After excluding voids less than 10% of estimated bladder capacity (6/50), and alarms triggered by stool, we found on linear regression analysis that use of alarm was associated with a mean decrease of 21.09 mL (95% CI -40.60 to -1.58, p=0.035) in PVR volume, when adjusting for patient weight (Figure 1). Every 1 kg increase in weight was also associated with a mean increase of 1.36 mL (95% CI 0.53 to 2.19, p=0.002) in PVR volumes. Median number of detected voids were also significantly different in the alarm versus routine care periods (3 vs. 1, p=0.0312). No adverse events occurred during the study sessions. CONCLUSIONS: An enuresis alarm facilitated detecting significantly more voids and smaller PVR volume in a population of complex non-verbal, diaper-voiding patients. Such alarms may prove useful to more accurately measure PVR in this challenging population. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e839 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Peter Y. Cai More articles by this author Andrea Balthazar More articles by this author Regina L. Tham More articles by this author Badar Omar More articles by this author Sangeeta Mauskar More articles by this author Walter Wickremasinghe More articles by this author Bartley G. Cilento More articles by this author Caleb P. Nelson More articles by this author Expand All Advertisement PDF downloadLoading ...

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