Constipation and Lower Urinary Tract Dysfunction in Children and Adolescents: A Population-Based Study

Abstract

ObjectiveTo evaluate the correlation between constipation and lower urinary tract dysfunction (LUTD) and nocturnal enuresis in a population-based study.Material and methodsThis is a cross-sectional study. The criteria for inclusion were children and adolescents of between 5 and 17 years and who agreed to sign the informed consent form. The study excluded students with neurological problems or who had documented abnormalities of the urinary tract. To identify the presence and severity of LUTD, we used the Voiding Dysfunction Symptom Score (DVSS). To evaluate the presence of constipation, Rome III questionnaire was used.ResultsWe interviewed 829 children and adolescents, of which 416 (50.18%) were male. The mean (SD) age was 9.1 (±2.9) years. The overall prevalence of LUTD was 9.1%, predominantly in girls (15 versus 3.1%, p < 0.001). Constipation was found in 9.4% of boys and 12.4% of girls (p = 0.169). Constipated children were 6.8 times more likely to have LUTD than those not constipated (p < 0.001, coefficient and correlation of 0.411). Constipation was found in 8.2% of children without LUTD and in 35.2% of children with LUTD. We performed multivariate analysis to identify urinary symptoms that are independent predictors of the presence of constipation. The presence of infrequent urination (p = 0.004) and holding maneuvers (p < 0.001) were independent predictors. It was noted also noted that constipated children, according to the Rome III criteria, possess a worse DVSS (p < 0.001). Regarding the presence of nocturnal enuresis, 12.6% of children and adolescents had constipation in association with this symptom. However, this relationship was not statistically significant (p = 0.483).ConclusionConstipated children were 6.8 times more likely to have LUTD than those not constipated. Among the urinary symptoms, infrequent voiding and holding maneuvers are independent factors of urinary expressions in constipated children. Children with more severe constipation have more prominent urinary symptoms. The presence of enuresis was not associated with constipation.

Functional Constipation and Overactive Bladder in Women: A Population-Based Study

“…FC was significantly associated with OAB in this sample. This finding is in line with others studies that reported the same association (3,4,5) . Studies has been theorizing about the important role played by the more distal segments of the colon in the development of overactive bladder (4,5) .…”

“…The association between FC and urinary symptoms has been well described in the pediatric population. In a recent study, our research group showed that a constipated child is 6.8 times more likely to develop lower urinary tract dysfunction (3) . In adults, an association between urinary disorders and FC has also been registered, with FC being more common in individuals with overactive bladder (OAB) than in those without OAB (4) .…”

Common urological problems in children: primary nocturnal enuresis

“…Children with functional constipation are 6.8 times more likely to have lower urinary tract symptoms, and these patients have higher Voiding Dysfunction Symptom Scores. 23 The rate of constipation is also much higher in children with urinary incontinence. After treating the constipation, urinary incontinence improves, especially in adolescents.…”

Association Between Duration of Constipation and Frequency of Urinary Tract Infection in Children

“…Hakimzadeh et al showed that most cases of constipation were in the group of 2 -7 years (84.47%) (8). In the Sampaio study, the mean age of the patients was nine years (7 -11 years) (14). This difference may be related to the difference in the participants' age in the studies (1 -12 years vs. 5 -17 years).…”