Voiding school as a treatment for daytime incontinence or enuresis: Assessing the effectiveness of intervention by measuring changes in wetting episodes

Most urotherapy interventions are planned for children with daytime incontinence or symptoms, and are based on individual education. This study conducted a voiding school (VS) program with groups of 4–6 children with daytime incontinence or enuresis with or without daytime symptoms. The aim of this quasi-experimental study with a one-group pretest–posttest design was to assess the effectiveness of the VS intervention for treating children's daytime incontinence or enuresis. Sixty-nine 6–12-year-old children with incontinence classified as treatment resistant participated in the VS at an outpatient clinic. Based on a power analysis, a sample of 52 participants was required. The VS involved two whole-day group visits 2 months apart. The educational content of the intervention was based on the International Children's Continence Society's standards for urotherapy, and was delivered with child-oriented teaching methods, including group discussions with peers. The primary outcome measure was the number of dry days and nights. The amount of wetting was also estimated, and the frequency of voiding measured. Data were collected with 1-week voiding diaries before and after each visit. Changes in dependent variables between four measurement points was measured by using repeated measures variance analysis. The long-term effectiveness was evaluated from patient records concerning 3-month follow-up phone calls or other contacts 8–18 months after the VS. Fifty-eight children, 34 girls and 24 boys, completed the study. Twelve children had daytime incontinence, 18 had enuresis, and 28 had both. The number of dry days increased from a mean of 3.5–5.3 (P