JMIR Publications

ABSTRACT

Background:

Urinary incontinence affects around 7-10% of children during the day and 9-12% during the night. Once anatomical and neurogenic causes are ruled out, treatment mainly involves lifestyle advice and behavioral methods. However, motivation and adherence to these methods, essential for success, are often low. Traditional tools, such as pen-and-paper solutions, may feel outdated to today’s ‘digital native’ children. As healthcare evolves with technology, traditional UI management tools may no longer meet children’s needs, potentially affecting their motivation and adherence.

Objective:

Our objective was to identify innovative, tech-driven and digital tools for managing pediatric urinary incontinence as alternatives to traditional methods and provide an overview of their supporting evidence.

Methods:

This scoping review followed PRISMA-ScR guidelines, with a search conducted in March 2022 across PubMed, Web of Science, and Cochrane Library, without date limits. The review focused on innovative, tech-driven and digital tools for pediatric urinary incontinence management, covering a wide range of dysfunctions and behavioral methods. Articles involving adults, lacking results, not in English, or missing full texts were excluded. From 2030 articles retrieved, 60 were included after screening, with 6 additional articles identified through cross-references, resulting in a total of 66 included articles.

Results:

The field of pediatric urinary incontinence demonstrates a considerable level of innovation, as evidenced by the inclusion of 66 studies, with nearly one-third (38%, n=25/66) focusing on nocturnal enuresis. Most studies were randomized controlled trials (n=14) or validation studies (n=13), and over one-third (38%, n=25/66) assessed patient experience outcomes such as satisfaction, motivation, and usability. Our analysis led to the identification and classification of six main categories of tools: (i) mobile health (n=7), (ii) serious games (n=7), (iii) reminder technology (n=6), (iv) educational media (n=12), further divided into video (n=5) and other media (n=7), (v) telehealth and remote patient monitoring (n=13), with subcategories of communication (n=5) and technological advances (n=8), and (vi) enuresis alarm innovations (n=21), further divided into novel configurations (n=8) and pre-void alarms (n=13).

Conclusions:

Many of the tools identified in this review show great promise as feasible and effective alternatives to traditional methods. They engage children well, improving compliance and leading to high satisfaction and preference, while also having the potential to save time for healthcare providers. However, their superiority over traditional methods remains unclear due to study limitations and conflicting results. Additionally, managing pediatric UI is complex due to its multifaceted nature, requiring accurate diagnosis and tailored interventions that consider clinical signs, child characteristics, and stakeholder involvement. We propose that future tools evolve into holistic, adaptive, and personalized ecosystems that align with stakeholders' needs by integrating diverse strategies for urinary incontinence management. Combining different tool categories identified in this review may provide a framework for creating these ecosystems.