Using Computer Games to Help with Pediatric Incontinence
Madison, Wisconsin - Pediatric incontinence, or daytime wetting, affects more than 10 million children nationwide. Traditionally, it has been evaluated with invasive tests and treated with a combination of medication and surgery.
Thanks to an innovative non-invasive evaluation and treatment program at UW Health's American Family Children's Hospital in Madison, Wisconsin, incontinence and related issues, including recurring urinary tract infections, are successfully treated through a program comprised of education and biofeedback using computer games.
According to Patrick McKenna, MD, chief of pediatric urology at American Family Children's Hospital, the program is designed to treat children who are unable to be toilet trained or who have been previously trained and then start having accidents.
He explains, "Many children come to the program at age four, when parents realize they are not able to successfully potty-train. But we also have adolescents who have been seeking help for years who find success with our therapy."
The therapy is a breakthrough in treating pediatric incontinence. It uses computer games originally developed by NASA to help astronauts practice muscle strengthening while experiencing weightlessness. The games use biofeedback to teach children how to correctly flex and relax the pelvic muscles that control the bladder.
The treatment is noninvasive and very private. Children are fully dressed and hooked up the computer game using small EKG-like pads. The children then must correctly use their abdominal and pelvic muscles to master the game, in this case, a golf game.
"Doing this correctly or incorrectly," says McKenna, "is the difference between a drive or a slice."
The game provides biofeedback to help children understand how to use their muscles to further master the game.
McKenna says, "It can be very difficult to teach children what muscles to contract and relax. That is why the games are such an important part of the program."
Equally important is the education component. Using a four-point "elimination education" program, nurse practitioners focus on diet – eating enough fiber and drinking enough water – and hygiene, which includes proper wiping and no bubble baths.
McKenna says, "This education is crucial to the program's success and would not be possible without the dedication of our nursing staff. In fact, this component alone is so powerful that it can cure about 20 percent of our patients."
The treatment has been very successful in helping children achieve dryness.
"And once daytime dryness is achieved," explains McKenna, "it usually helps any nighttime wetting issues as well."
In helping patients achieve dryness and learn proper voiding habits, the program has the added benefit of decreasing recurring urinary tract infections by 95 percent and has decreased pediatric surgeries for vesicoureteral reflux from 120 annually to close to zero. The program's success is a direct result of the dedication and commitment of staff, as well as that of the children and their families.
McKenna notes, "Often people look to medication or surgery as a quick fix to solve their problem. This program requires the commitment of time for the education sessions and treatment - and the results are well worth the effort."
McKenna reflects on a patient who had been dealing with incontinence for 11 years. "As children grow, there are social ramifications, including embarrassment and the inability to spend extended time with friends. This child, after 11 years of seeking treatment, went through three sessions with us and achieved dryness."
Date Published: 03/26/2014