Posterior Tibial Nerve Stimulation in Children with Lower Urinary Tract Dysfunction: A Mixed-Methods Analysis of Experiences, Quality of Life and Treatment Effect.

BACKGROUND: Posterior tibial nerve stimulation (PTNS) is one of the treatment modalities for children with therapy-refractory lower urinary tract dysfunction (LUTD). This study used a mixed-methods analysis to gain insight into the experiences of children treated with PTNS and their parents, the effect of treatment on quality of life (QOL) and the effect of PTNS on urinary symptoms. METHODS: Quantitative outcomes were assessed through a single-centre retrospective chart analysis of all children treated with PTNS in a group setting between 2016-2021. Voiding parameters and QOL scores before and after treatment were compared. Qualitative outcomes were assessed by an explorative study involving semi-structured interviews transcribed verbatim and inductively analysed using the constant-comparative method. RESULTS: The data of 101 children treated with PTNS were analysed. Overall improvement of LUTD was seen in 42% and complete resolution in 10%. Average and maximum voided volumes significantly increased. QOL improved in both parents and children independent of the actual effect on urinary symptoms. Interviews revealed PTNS to be well-tolerated. Facilitating PTNS in a group setting led to feelings of recognition in both children and parents. CONCLUSIONS: PTNS is a good treatment in children with therapy-refractory LUTD and provides valuable opportunities for peer support if given in a group setting.

Update on universal annual influenza immunization recommendations for children.

PURPOSE OF REVIEW: To provide an update of current recommendations and research findings on universal annual influenza immunization of children. RECENT FINDINGS: The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention and the American Academy of Pediatrics now recommend annual influenza vaccination for all children 6 months through 18 years. New research has examined the effect of 'herd immunity' associated with immunizing all school-aged children, the suboptimal antigenic match between the trivalent vaccine strains and circulating virus strains of last 2007-2008 influenza season, the efficacy of live attenuated influenza vaccine versus trivalent inactivated influenza vaccine, and the tolerance for influenza vaccine in infants less than 6 months of age. With a goal of improving the overall rates of influenza immunization and an eye toward the anticipated increase in volume with expansion of the universal recommendations in children, Advisory Committee on Immunization Practices and American Academy of Pediatrics emphasize the value of extending the timeframe for immunization beyond December and into April, establishing school-based immunization programs and other alternative vaccination sites outside medical homes, and conducting large, population-based studies that examine the overall impact of universal childhood influenza immunization. SUMMARY: Annual influenza vaccination recommendations have been expanded, and research continues on vaccine efficacy, administration, and cost associated with vaccinating all school-aged children.