Is there a unique symptom in lower urinary tract dysfunction in children?

Abstract

Objectives Lower urinary tract symptoms (LUTS), particularly urgency, incontinence and intermittency are common in children and it is suggested that the specific symptoms may be used for definite diagnosis for LUT dysfunction (LUTD). This study was performed to investigate the relationship between each LUTD and its associated symptoms, using uroflowmetry/electromyography (UF/EMG) as a diagnostic tool. Methods Each patient was categorized into one of four LUT conditions which were overactive bladder (OAB), dysfunctional voiding (DV), underactive bladder and primary bladder neck dysfunction (PBND), according to UF/EMG results. Patients' complaints and findings were documented by using voiding dysfunction symptom score, bladder diary, urine analysis and ultrasonography. In addition, a detailed history of bowel habits (including use of Rome III criteria) was obtained. Results There were 189 children of which 106 were female. The OAB was the largest group including 91 patients, followed by the DV group which had 61 patients. The symptoms specific to any LUTD group were constipation and hesitancy (P < .05). Hesitancy was present in 89.4% with PBND and constipation was present in 78.6% of patients with DV. None of other symptoms were able to differentiate any LUTD group from the other. Conclusions While certain symptoms are often presumed by clinicians to imply specific diagnoses, the main outcome of this study is that there is a generally weak correlation between the specificity of symptoms and LUTD. Symptoms‐based approach may lead to misdiagnosis in LUTD. Thus, it may be essential to focus on the underlying pathologies and UF/EMG test may help this.

Prevalence of lower urinary tract symptoms in children with early‐treated infantile‐onset Pompe disease: A single‐centre cross‐sectional study

“…In the present study, there were no significant differences noted in the total DVSS scores and voiding dysfunction diagnoses when the children's bell‐shaped uroflow curves were compared to those with nonbell‐shaped uroflow curves. Özen et al reported weak correlations between symptom specificity, symptom clusters, and lower urinary tract dysfunction 24 . Thus, a symptoms‐based approach may lead to misdiagnoses in cases of lower urinary tract dysfunction.…”

“…Özen et al reported weak correlations between symptom specificity, symptom clusters, and lower urinary tract dysfunction. 24 Thus, a symptoms-based approach may lead to misdiagnoses in cases of lower urinary tract dysfunction. Lower urinary tract dysfunction is associated with urinary tract infections, vesicoureteral reflux, renal scarring, and psychological changes.…”

Prevalence of Lower Urinary Tract Symptoms in Children with Attention-Deficit/Hyperactivity Disorder: Comparison of Hospital and Population-Based Cohorts of 13,000 Patients

“…Due to modernized lifestyle, the prevalence of LUTS in children increases because of inappropriate voiding habits and toilet training [ 4 , 5 ]. Epidemiologically, the ratio of LUTS in school-aged children is around 2 to 20 percent, mostly urgency, intermittency, urinary incontinence and enuresis, which affect social limiting and decrease health related quality of life of the children and the parents [ 4 , 6 ].…”