Use of timed alarm device for pediatric daytime urinary incontinence

Meta-analysis of comparative studies

Authors

  • Michael E. Chua Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto
  • Mandy Rickard Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto
  • Jin Kyu Kim Temerty Faculty of Medicine, University of Toronto
  • Natasha Brownrigg Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto
  • Joana Dos Santos Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto
  • Luzelle Kate Aba Institute of Urology, St. Luke's Medical Center, Quezon City
  • Armando Lorenzo Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto
  • Niraj Mistry Department of Pediatrics, The Hospital for Sick Children, Toronto

DOI:

https://doi.org/10.5489/cuaj.8113

Keywords:

pediatric, daytime urinary incontinence

Abstract

INTRODUCTION: This meta-analysis aimed to determine the comparative effectiveness of timed alarm device-assisted urotherapy vs. standard urotherapy alone in managing pediatric daytime urinary incontinence (pDUI).

METHODS: A systematic literature search was performed in December 2021, with an update search in July 2022. Comparative studies assessing the pDUI treatment effectiveness of timed alarm device-assisted urotherapy vs. urotherapy alone were identified and evaluated according to Cochrane collaboration recommendations. The assessed outcome includes pDUI complete response and adherence rates. Relative risk (RR) with 95% confidence intervals (CI) was extrapolated. A random-effects model was used to pool effect estimates. Heterogeneity was assessed with sensitivity and subgroup analysis performed according to study design and comparative group characteristics. GRADE criteria were used to assess evidence certainty. (PROSPERO CRD42022299173).

RESULTS: Four studies (three randomized controlled trials [RCTs] and one retrospective cohort) with 635 cases were included. The pooled effect estimates of pDUI complete response showed no differences between intervention groups (RR 1.20, 95% CI 0.81, 1.76). Pooled effect estimates for treatment adherence were generated from two studies, which showed significantly better adherence for the timed-alarm device group (RR 2.97, 95% CI 1.46, 6.06). Significant interstudy heterogeneity was noted; the source is likely from the study design and comparator device characteristics. The quality of evidence was assessed to be of very low certainty.

CONCLUSIONS: Based on very low certainty evidence, timed alarm device-assisted urotherapy does not seem to have the advantage of complete treatment response over standard urotherapy alone in managing pDUI; however, a timed-alarm device is likely able to improve urotherapy treatment adherence.

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Published

2022-12-06

How to Cite

Chua, M. E., Rickard, M. ., Kim, J. K. ., Brownrigg, N. ., Dos Santos, J. ., Aba, L. K. ., Lorenzo, A. ., & Mistry, N. . (2022). Use of timed alarm device for pediatric daytime urinary incontinence: Meta-analysis of comparative studies. Canadian Urological Association Journal, 17(4), 129–36. https://doi.org/10.5489/cuaj.8113

Issue

Vol. 17 No. 4 (2023): CUAJ April

Section

Review

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