Development of a Symptom Score for Dysfunctional Elimination Syndrome

Afshar, Kourosh; Mirbagheri, Amir; Scott, Heidi; MacNeily, Andrew E.

doi:10.1016/j.juro.2009.03.009

Cited by 122 publications

(116 citation statements)

References 10 publications

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“…Recently, the pediatric urology community has worked to develop questionnaires that might help to quantify BBD symptoms in a reliable and accurate manner. The BBD spectrum is classified by the International Children's Continence Society (ICCS) (9,14). A validated bladder/bowel dysfunction questionnaire is a useful tool in the pediatric urology clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Reliability and validity of the Bladder and Bowel Dysfunction Questionnaireamong Turkish children

Narter¹,

Tarhan²,

Narter³

et al. 2017

Turk J Med Sci

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IntroductionBladder bowel dysfunction (BBD) is common clinical problem in pediatric urology patients. If a specialist takes a medical history meticulously during ambulatory visits by these patients, it can be detected just about 40% (1).These patients present with lower urinary tract symptoms (LUTS) of storage and/or emptying. When this disorder is associated with abnormal bowel patterns such as constipation and encopresis, the term bladder bowel dysfunction (BBD) is used. BBD can lead to development of urinary tract infection (UTI), incontinence, unfavorable outcome on vesicourethral reflux (VUR), and upper or lower urinary tract damage in children. Regarding the sex distribution of this problem, a female to male ratio as high as 5:1 for BBD is reported in the literature (2). However, the epidemiological data about this problem can vary, depending on the definition of BBD.Diagnostic procedures should include taking a medical history, physical examination, voiding and bowel diary, urinalysis, urine culture, urinary ultrasonography, and complementary investigations. In contrast, there is no consensus about reliable and valid methods for evaluation of this problem. There are a few published questionnaires that quantify BBD. Additionally, the International Continence Society (ICS) recommends the use of the Rome III criteria for constipation in children. Extensively, the Bristol Stool Form Scale (BSFS) is used for definition of constipation. Recently, new diagnostic methods were developed for the diagnosis and follow up of dysfunctional micturition symptoms. One of them is named the Bladder and Bowel Dysfunction Questionnaire (BBDQ).In this context, we aimed to evaluate the reliability and validity of a Turkish version of the BBDQ in pediatric urology patients. Patients and methods Study designBetween October 2013 and April 2014, a total of 193 consecutive male (n = 94) and female (n = 99) children were enrolled in this study. While 103 patients with various Background/aim: We developed a Turkish version of the Bladder and Bowel Dysfunction Questionnaire (BBDQ) and evaluated its psychometric properties among Turkish pediatric patients. Materials and methods:The BBDQ was translated into Turkish and then it was back-translated into English. A total of 193 patients were asked to complete the Turkish version of the BBDQ as well as the Dysfunctional Voiding and Incontinence Scoring System (DVISS). In addition, 39 children completed the same questionnaires twice at 2-week intervals for test-retest evaluation.Results: Cronbach's alpha coefficient of the BBDQ was 0.727. Reliability of the test/retest was 0.759 (P < 0.001). Area under the curve of the receiver operating characteristic plot was 0.765. There were statistically significant differences in BBDQ scores between the controls and patients (P < 0.001). Analysis demonstrated moderate convergent validity against the DVISS (r: 0.78, r 2 : 0.601, P < 0.0001). Conclusion:The Turkish version of the BBDQ is a reliable and valid instrument for Turkish pediatric patients with b...

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Section: Discussionmentioning

confidence: 99%

Reliability and validity of the Bladder and Bowel Dysfunction Questionnaireamong Turkish children

Narter¹,

Tarhan²,

Narter³

et al. 2017

Turk J Med Sci

View full text Add to dashboard Cite

show abstract

“…13 The follow-up included VCUG at 3 months and ultrasound at 3 months and 1 year. We excluded patients with previous endoscopic treatment of VUR, active infection at the time of injection, untreated dysfunctional elimination syndrome defined by 3-day diary and validated questionnaires (DVSS, 14 Rome III 15 ), and absence of follow-up imaging studies. We also excluded patients with neurogenic bladder, VUR grade V, and history of bladder exstrophy, due to the complexity of these cases and their variability of success with endoscopic injection.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of dextranomer hyaluronic acid and polyacrylamide hydrogel in endoscopic treatment of vesicoureteral reflux: A comparative study

Blais

Morin

Cloutier

et al. 2015

CUAJ

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Introduction: Various bulking agents are available for vesicoureteral reflux (VUR) endoscopic treatment, but their inconsistent success rates and costs are concerns for urologists. Recently, polyacrylamide hydrogel (PAHG) has been shown to have a good overall success rate, which seems comparable to dextranomer hyaluronic acid (Dx/HA), currently the most popular bulking agent. Our objective was to compare the short-term success rate of PAHG and Dx/ HA for VUR endoscopic treatment in children. Methods: We performed a prospective non-randomized study using PAHG and Dx/HA to treat VUR grades I to IV in pediatric patients. All patients underwent endoscopic sub-ureteric injection of PAHG or Dx/HA, using the double-HIT technique, followed by a 3-month postoperative renal ultrasound and voiding cystourethrogram. Treatment success was defined as the absence of de novo or worsening hydronephrosis and absence of VUR. Results: A total of 90 pediatric patients underwent an endoscopic injection: 45 patients (78 ureters) with PAHG and 45 patients (71 ureters) with Dx/HA. The mean injected volume of PAHG and Dx/ HA was 1.1 mL and 1.0 mL, respectively. The overall success rate 3 months after a single treatment was 73.1% for PAHG and 77.5% for Dx/HA. Postoperatively, 1 patient in each group presented with acute pyelonephritis and 2 patients in the Dx/HA group developed symptomatic ureteral obstruction. Conclusion: Success rates of PAGH and Dx/HA in endoscopic injections for VUR treatment were comparable. The rate of resolution obtained with Dx/HA was equivalent to those previously published. The lower cost of PAHG makes it an interesting option.

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“…The Vancouver Symptom Score for Dysfunctional Elimination Syndrome (VSSDES) has also been validated in a large cohort in the U.S. and has proven effective for diagnosis and evaluation of treatment of BBD. 18,19 The most complementary test indicated for the investigation of LUTS is urinalysis. In the presence of leukocyturia, pyuria, bacteriuria, and/or nitrates, a urine culture should be obtained from a reliable source to rule out UTI (as previously discussed).…”

Section: Diagnostic Approachmentioning

confidence: 99%

Bladder and bowel dysfunction in children: An update on the diagnosis and treatment of a common, but underdiagnosed pediatric problem

Santos

Lopes

Koyle

2017

CUAJ

131

126

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Bladder and bowel dysfunction (BBD) describes a spectrum of lower urinary symptoms (LUTS) accompanied by fecal elimination issues that manifest primarily by constipation and/or encopresis. This increasingly common entity is a potential cause of significant physical and psychosocial burden for children and families. BBD is commonly associated with vesicoureteral reflux (VUR) and recurrent urinary tract infections (UTIs), which at its extreme may lead to renal scarring and kidney failure. Additionally, BBD is frequently seen in children diagnosed with behavioural and neuropsychiatric disorders such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Patients with concomitant BBD and neuropsychiatric disorders have less favourable treatment outcomes. Early diagnosis and treatment of BBD are critical to avoid secondary comorbidities that can adversely impact children's kidney and bladder function, and psychosocial well-being. The majority of patients will improve with urotherapy, adequate fluid intake, and constipation treatment. Pharmacological treatment must only be considered if no improvement occurs after intensive adherence to at least six months of urotherapy ± biofeedback and constipation treatment. Anticholinergics remain the mainstay of medical treatment. Selective alpha-blockers appear to be effective for improving bladder emptying in children with non-neurogenic detrusor overactivity (DO), incontinence, recurrent UTIs, and increased post-void residual (PVR) urine volumes. Alpha-1 blockers can also be used in combination with anticholinergics when overactive bladder (OAB) coexists with functional bladder outlet obstruction. Minimally invasive treatment with onabotulinumtoxinA bladder injections, and recently neurostimulation, are promising alternatives for the management of BBD refractory to behavioural and pharmacological treatment.In this review, we discuss clinical presentation, diagnostic approach, and indications for behavioural, pharmacological, and surgical treatment of BBD in children based on a thorough literature review. Expert opinion will be used when scientific evidence is unavailable.

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Development of a Symptom Score for Dysfunctional Elimination Syndrome

Abstract: This new questionnaire is valid and reliable for diagnosing dysfunctional elimination syndrome. It can be used as a clinical or research instrument.

Cited by 122 publications

References 10 publications

Reliability and validity of the Bladder and Bowel Dysfunction Questionnaireamong Turkish children

Reliability and validity of the Bladder and Bowel Dysfunction Questionnaireamong Turkish children

Efficacy of dextranomer hyaluronic acid and polyacrylamide hydrogel in endoscopic treatment of vesicoureteral reflux: A comparative study

Bladder and bowel dysfunction in children: An update on the diagnosis and treatment of a common, but underdiagnosed pediatric problem

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