The following is a summary of “Role of Secondary Conservative Management Strategies in Bladder and Bowel Dysfunction: A Systematic Review and Meta-analysis,” published in the June 2024 issue of Pediatrics by Khondker et al.

This study aimed to assess the impact of secondary management strategies, in conjunction with urotherapy, on outcomes for children with bladder and bowel dysfunction (BBD). The review protocol was prospectively registered (CRD42023422168), and comprehensive searches were conducted in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and Scopus, covering all available data up to June 2023. Comparative studies that evaluated secondary management strategies versus conventional urotherapy alone were included in the analysis. Two researchers independently screened titles and abstracts, reviewed full-text articles, and extracted data about study characteristics, methodology, subjects, and results.

The systematic review and meta-analysis encompassed 18 studies involving 1,228 children. The findings indicated that secondary management strategies, such as home-based education, biofeedback, and physical therapy, were associated with a significant reduction in symptom burden, fewer recurrent urinary tract infections, and improved uroflowmetry findings compared to children who received only urotherapy for conservative management. Despite notable heterogeneity in reporting, the results consistently demonstrated the benefits of these additional conservative management strategies.

In conclusion, incorporating secondary conservative management strategies—such as home education, biofeedback, cognitive behavioral therapy, and physiotherapy-based education—alongside traditional urotherapy can significantly reduce urinary incontinence, infections, and abnormal uroflowmetry findings in children with BBD. This comprehensive approach highlights the importance of multi-faceted interventions in improving clinical outcomes for pediatric patients with bladder and bowel dysfunction.

Source: sciencedirect.com/science/article/abs/pii/S0022347624002555