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Pediatric Psychology in a Urology Division: Unifying Complex Medical and Mental Health Treatment

  • Pediatric Urology (C Long, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Although pediatric psychology is heavily involved in many medical divisions, its involvement in a urology division is still relatively new and its role continuously evolving and growing.

Recent Findings

This article reviews the limited research on the use of psychology in a urology division, including psychosocial struggles across urology diagnoses, dysfunctional voiding, and anxiety surrounding medical procedures and surgery. Urinary diagnoses and presenting problems seen by pediatric psychologists and medical providers at an urban children’s hospital are also included.

Summary

Based on the complex conditions and varied presenting concerns in a urology division, potential assessments and future research are suggested to help gather data for this population moving forward and expand the literature on urology psychology.

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Data Availability

The data that support the findings of this study are available from the corresponding author, [CMR], upon reasonable request.

References

Papers of particular interest, published recently, have been highlighted as: •   Of importance •• Of major importance

  1. •• Schast AP, Reiner WG. Pediatric psychology in genitourinary anomalies. Urol Clin of N Am. 2010;37:299–305. https://doi.org/10.1016/j.ucl.2010.03.013. In this study, the authors reviewed the importance of incorporating a pediatric psychologist into a urology division, which was still incredibly new to the field at the time. They reviewed the urological concerns observed in different age groups and the types of interventions to use with patients and families.

  2. Baskin LS, Kogan BA, Stock JA. Handbook of pediatric urology. 3rd ed. Philadelphia: Wolters Kluwer; 2019.

    Google Scholar 

  3. Diamond DA, Chan IHY, Holland AJA, Kurtz MP, Nelson C, Estrada CR Jr, et al. Advances in paediatric urology. Lancet. 2017;390:1061–71. https://doi.org/10.1016/S0140-6736(17)32282-1.

    Article  Google Scholar 

  4. • Wolfe-Christensen C, Veenstra AL, Kovacevic L, Elder JS, Lakshmanan Y. Psychosocial difficulties in children referred to pediatric urology: a closer look. Urology. 2012;80(4):907–13. https://doi.org/10.1016/j.urology.2012.04.077. The authors advocated for psychosocial screening for pediatric urology patients, especially children that are struggling with voiding dysfunction and enuresis. The findings of higher distress among the voiding dysfunction population are consistent with results of higher reported distress in other pediatric medical conditions in the literature.

  5. Zhao PT, Velez D, Faiena I, Creenan EM, Barone JG. Bullying has a potential role in pediatric lower urinary tract symptoms. J Urol. 2014;193:1743–8. https://doi.org/10.1016/j.juro.2014.08.123.

    Article  Google Scholar 

  6. Champeau AM: Daytime urinary incontinence/bladder and bowel dysfunction (in the otherwise healthy child). In Baskin LS, Kogan BA, Stock JA. Handbook of pediatric urology. Philadelphia: Wolters Kluwer; 2019.

  7. Lopes M, Ferraro A, Filho UD, Kuckzinski E, Koch VH. Quality of life of pediatric patients with lower urinary tract dysfunction and their caregivers. Pediatr Nephrol. 2011;26:571–7. https://doi.org/10.1007/s00467-010-1744-2.

    Article  Google Scholar 

  8. Arnhym AM: Nocturnal enuresis. In Baskin LS, Kogan BA, Stock JA. Handbook of pediatric urology. Philadelphia: Wolters Kluwer; 2019.

  9. Sureshkumar P, Jones M, Caldwell PHY, Craig JC. Risk factors for nocturnal enuresis in school-age children. J Urol. 2009;182:2893–9. https://doi.org/10.1016/j.juro.2009.08.060.

    Article  Google Scholar 

  10. Pandey S, Oza HJ, Shah H, Vankar GK. Rate and risk factors of nocturnal enuresis in school going children. Ind Psychiatry J. 2019;28(2):306–11. https://doi.org/10.4103/ipj.ipj_15_18.

    Article  Google Scholar 

  11. Barthel D, Ravens-Sieberer U, Nolte S, Thyen U, Klein M, Walter P, et al. Predictors of health-related quality of life in chronically ill children and adolescents over time. J Psychosom Res. 2018;109:63–70. https://doi.org/10.1016/j.jpsychores.2018.03.005.

    Article  CAS  Google Scholar 

  12. Bachmann C, Ackmann C, Janhsen E, Steuber C, Bachmann H, Lehr D. Clinical evaluation of the short-form pediatric enuresis module to assess quality of life. Neurouro Urodyn. 2010;29:1397–402. https://doi.org/10.1002/nau.20896.

    Article  Google Scholar 

  13. Arlen AM, Kirsch SS, Seidel NE, Garcia-Roig M, Smith EA, Kirsch AJ. Health-related quality of life in children with prune-belly syndrome and their caregivers. Urology. 2015;87:224–7. https://doi.org/10.1016/j.urology.2015.09.028.

    Article  Google Scholar 

  14. Hurrell RA, Fullwood C, Keys J, Dickson AP, Fishwick J, Whitnall B, et al. Psychosocial screening at paeditric BEEC clinics: a pilot evaluation study. J Pediatr Urol. 2015;11:79e1–79e6. Doi: https://doi.org/10.1016/j.jpurol.2014.10.013.

  15. VP Bhatia ME Hilliard PF Austin AG Mittal 2021 Evaluating quality of patient-reported outcome measures in patients with hypospadias J Pediatr Urol. 17;1:50-58. https://doi.org/10.1016/j.jpurol.2020.11.043

  16. Bonnett KM, Fuller LL, Cooper CS, Arlen AM, Storm DW. The Iowa Voiding Improvement Partnership experience: early observations with a collaborative uro-psychologic clinic. J Pediatr Urol. 2017;13:391.e1-391.e6. https://doi.org/10.1016/j.jpurol.2017.05.024.

    Article  CAS  Google Scholar 

  17. Wenzel A (2021) Handbook of cognitive behavioral therapy, volume 1: overview and approaches. American Psychological Association Books, Washington DC.

  18. Burgu B, Aydogdu O, Gurkan K, Uslu R, Soygur T. Lower urinary tract conditions in children with attention deficit hyperactivity disorder: correlation of symptoms based on validated scoring systems. J Urol. 2011;185:663–8. https://doi.org/10.1016/j.juro.2010.09.116.

    Article  Google Scholar 

  19. Kaye JD, Palmer LS. Characterization and management of voiding dysfunction in children with attention deficit hyperactivity disorder. Urology. 2010;76:220–4. https://doi.org/10.1016/j.urology.2010.01.026.

    Article  Google Scholar 

  20. Crimmins CR, Rathbun SR, Husmann DA. Management of urinary incontinence and nocturnal enuresis in attention-deficit hyperactivity disorder. J Urol. 2003;170:1347–50. https://doi.org/10.1097/01.ju.0000084669.59166.16.

    Article  CAS  Google Scholar 

  21. Brownrigg N, Braga LH, Rickard M, Farrokhyar F, Easterbrook B, Dekirmendjian A, et al. The impact of a bladder training video versus standard urotherapy on quality of life of children with bladder and bowel dysfunction: a randomized controlled trial. J Pediatr Urol. 2017;13:374.e1-374.e8. https://doi.org/10.1016/j.jpurol.2017.06.005.

    Article  CAS  Google Scholar 

  22. Arlen AM, Cooper CS, Leong T. Role of body mass index in school-aged children with lower urinary tract dysfunction: does weight classification predict treatment outcome? J Pediatr Urol. 2017;13:454e1–454e5. https://doi.org/10.1016/j.jpurol.2017.03.033.

  23. De Bruyne E, Van Hoecke E, Van Gompel K, Verbeken S, Baeyens D, Hoebeke P, et al. Problem behavior, parental stress and enuresis. J Urol. 2009;182:2015–21. https://doi.org/10.1016/j.juro.2009.05.102.

    Article  Google Scholar 

  24. Selvi I, Hajiyev P, Ekberli G, Baklaci U, Soygur T, Burgu B. The effects of primary and recurrent pediatric urological surgeries on parental anxiety levels. J Pediatr Uro. 2020;16:652e1–652.e9. https://doi.org/10.1016/j.jpurol.2020.07.036.

  25. A Fonseca B Nazare MC Canavarro 2016 Medical information concerning an infant’s congenital anomaly: successful communication to support parental adjustment and transition Disabil Health J. 9:150-156 https://doi.org/10.1016/j.dhjo.2015.08.005

  26. Van Herzeele C, Dhondt K, Roles SP, Raes A, Hoebeke P, Groen L, et al. Desmopressin (melt) therapy in children with monosymptomatic nocturnal enuresis and nocturnal polyuria results in improved neuropsychological functioning and sleep. Pediatr Nephrol. 2016;31:1477–84. https://doi.org/10.1007/s00467-016-3351-3.

    Article  Google Scholar 

  27. Hussong, J, Mattheus, H, Wachs, S, Equit, M, von Gontard, A. Evaluation of a bladder and bowel training program for therapy-resistant children with incontinence. J Pediatr Urol. 2021;17:302e1–302.e8. https://doi.org/10.1016/j.jpurol.2021.01.042.

  28. Farhat W, Bagli DJ, Capolicchio G, O’Reilly S, Merguerian PA, Khoury A, et al. The dysfunctional voiding scoring system: quantitative standardization of dysfunctional voiding symptoms in children. J Urol. 2000;164(3):1011–5. https://doi.org/10.1016/S0022-5347(05)67239-4.

    Article  CAS  Google Scholar 

  29. Ebiloglu T, Kaya E, Kopru B, Topuz B, Irkilata HC, Kibar Y. Biofeedback as a first-line treatment for overactive bladder syndrome refractory to standard urotherapy in children. J Pediatr Urol. 2016;12:290e1–290e7. https://doi.org/10.1016/j.jpurol.2016.02.018.

  30. Vesna ZD, Milica L, Stankovic I, Marina V, Andjelka S. The evaluation of combined standard urotherapy, abdominal and pelvic floor retraining in children with dysfunctional voiding. J Pediatr Urol. 2011;7:336–41. https://doi.org/10.1016/j.jpurol.2011.02.028.

    Article  Google Scholar 

  31. McKenna P. Current role of biofeedback for pediatric lower urinary tract symptoms. J Urol. 2015;193:14–5. https://doi.org/10.1016/j.juro.2014.10.058.

    Article  Google Scholar 

  32. Desantis DJ, Leonard MP, Preston MA, Barrowman NJ, Guerra LA. Effectiveness of biofeedback for dysfunctional elimination syndrome in pediatrics: a systematic review. J Pediatr Urol. 2011;7:342–8. https://doi.org/10.1016/j.jpurol.2011.02.019.

    Article  Google Scholar 

  33. Selekman RE, Sanford MT, Ko LN, Allen IE, Copp H. Does perception of catheterization limit its use in pediatric UTI? J Pediatr Urol. 2017;13:48.e1-48.e6. https://doi.org/10.1016/j.jpurol.2016.09.006.

    Article  Google Scholar 

  34. Sutherland RS: Spina bifida/neurogenic bladder. In Baskin LS, Kogan BA, Stock JA. Handbook of pediatric urology. Philadelphia: Wolters Kluwer; 2019.

  35. Chase J, Bower W, Gibb S, Schaeffer A, von Gontard A. Diagnostic scores, questionnaires, quality of life, and outcome measures in pediatric continence: a review of available tools from the International Children’s Continence Society. J Pediatr Urol. 2018;14:98–107. https://doi.org/10.1016/j.jpurol.2017.12.003.

    Article  Google Scholar 

  36. •• Wolfe-Christensen C, Guy WC, Mancini M, Kovacevic LG, Lakshmanan Y. Evidence of need to use self-report measures of psychosocial functioning in older children and adolescents with voiding dysfunction. J Urol. 2016;195:1570–4. https://doi.org/10.1016/j.juro.2015.11.045. In this study, the authors advocate for the use of self-report questionnaires, alongside parent measures, when assessing pediatric patients ages 11-16 with voiding dysfunction. Up to one third of the participants that reported psychosocial distress had parent counterpart measures that did not observe any concerns. Therefore, self-report measures can capture more psychosocial difficulties that may not be apparent to the caregiver.

  37. MacNeily AE. Should psychological assessment be a part of incontinence management in children and adolescents? J Urol. 2016;195:1327–8. https://doi.org/10.1016/j.juro.2016.02.071.

    Article  Google Scholar 

  38. • Selewski DT, Massengill SF, Troost JP, Wickman L, Messer KL, Herreshoff E, et al. Gaining the Patient Reported Outcomes Measurement Information System (PROMIS) perspective in chronic kidney disease: a Midwest pediatric nephrology consortium study. Pediatr Nephrol. 2014;29:2347–56. https://doi.org/10.1007/s00467-014-2858-8. The authors evaluated the use of the PROMIS measure with children diagnosed with chronic kidney disease to determine the psychosocial impact of the medical concerns on the child. This is the instrument that has been used widely at different institutions and will be used with our pediatric urology population.

  39. Irwin DE, Stucky BD, Thissen D, Dewitt EM, Lai JS, Yeatts K, et al. Sampling plan and patient characteristics of the PROMIS pediatrics large-scale survey. Qual Life Res. 2010;19:585–94. https://doi.org/10.1007/s11136-010-9618-4.

    Article  Google Scholar 

  40. Claeys W, Roth JD, Hoebeke P. Barriers in transitioning urologic patients from pediatric to adult care. J Urol. 2021;17(2):144–52. https://doi.org/10.1016/j.jpurol.2020.12.020.

    Article  Google Scholar 

  41. Woodhouse CRJ, Neild GH, Yu RN, Bauer S. Adult care of children from pediatric urology. J Urol. 2011;187:1164–71. https://doi.org/10.1016/j.juro.2011.12.011.

    Article  Google Scholar 

  42. Bower WF, Christie D, DeGennaro M, Latthe P, Raes A, Romao RLP, et al. The transition of young adults with lifelong urological needs from pediatric to adult services: an international children’s continence society position statement. Neurourol Urodyn. 2016;36(3):811–9. https://doi.org/10.1002/nau.23039.

    Article  Google Scholar 

  43. Lambert SM. Transitional care in pediatric urology. Sem Pediatr Surg. 2015;24(2):73–8. https://doi.org/10.1053/j.sempedsurg.2015.01.004.

    Article  Google Scholar 

  44. Stephany HA, Ching CB, Kaufman MR, Squiers A, Trusler L, Clayton D, et al. Transition of urologic patients from pediatric to adult care: a preliminary assessment of readiness in spina bifida patients. Urology. 2016;85:959–63. https://doi.org/10.1016/j.urology.2014.12.019.

    Article  Google Scholar 

  45. Grimsby GM, Burgess R, Culber S, Schlomer BJ, Jacobs MA. Barriers to transition in young adults with neurogenic bladder. J Pediatr Urol. 2016;12:258e1–258e5. https://doi.org/10.1016/j.jpurol.2016.04.015.

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Authors and Affiliations

  1. Division of Urology, Civic Center Boulevard, Children’s Hospital of Philadelphia, Philadelphia, PA, 19141, USA

    Christina M. Rouse

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  1. Christina M. Rouse
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Rouse, C.M. Pediatric Psychology in a Urology Division: Unifying Complex Medical and Mental Health Treatment. Curr Urol Rep 24, 17–24 (2023). https://doi.org/10.1007/s11934-022-01127-4

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