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Diagnostic value of the pediatric lower urinary tract symptom score in children with overactive bladder

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Abstract

Purpose

The aims were (1) to assess the pediatric lower urinary tract symptom score (SS) prior to treatment as a means of determining severity of overactive bladder (OAB) and (2) to investigate relationships between SS results and those of standard diagnostic modalities.

Materials and methods

Symptom scores were recorded pre- and 6 months SS for 294 children with OAB unrelated to neurological disorder. Uroflowmetry–electromyography data, total bladder capacity, and a 2-day bladder diary were also recorded, and upper urinary tract deterioration was investigated as indicated. Overactive bladder was treated with standard approaches. No response to treatment was defined as 0–49 % reduction in OAB-related symptoms based on SS results. Non-responders underwent additional evaluations as indicated.

Results

Two hundred forty-one patients (97 %; mean age 9.8 ± 2.8 years; mean follow-up 11 months; range 6–18 months) completed the study. One hundred thirteen (47 %) required ultrasonography (USG), and those with abnormal USG had a significantly higher pre- and 6 months SS (p = 0.016). All non-responders (n = 38; 16 %) underwent urodynamics evaluation, 34 underwent spinal magnetic resonance imaging (MRI), 34 underwent voiding cystourethrography (VCUG), and 34 underwent dimercaptosuccinic acid scanning (DMSA). Non-responders with terminal detrusor hyperactivity had significantly lower SS after therapy (p = 0.09). Non-responders with abnormal MRI had higher pre- and 6 months SS than those with normal MRI. Thirteen (38 %) of the non-responders who required VCUG had vesicoureteral reflux (VUR), and this subgroup had higher pre-treatment SS (p = 0.030). Seven (21 %) of the non-responders who required DMSA had scarring, and all 7 had VUR. The subgroup with scarring had higher pre-treatment SS (p = 0.030).

Conclusion

Pediatric OAB patients with high 6 months SS have a higher incidence of additional upper urinary tract pathology. Those with low pre-treatment SS require fewer laboratory tests and other assessments. The SS tool can reduce the number of urodynamics evaluations, and other tests required to diagnose renal damage in children with OAB.

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References

  1. Sillén U, Brandström P, Jodal U et al (2010) The Swedish reflux trial in children: v. bladder dysfunction. J Urol 184(1):298–304

    Article  PubMed  Google Scholar 

  2. Nijman RJM, Bower W, Butler U et al (2005) Diagnosis and management of urinary incontinence and encopresis in children. In: Abrams P, Cardozo L, Khoury S et al (eds) Incontinence. Health Publication, Plymouth, p 965

    Google Scholar 

  3. Neveus T, vonGontard A, Hoebeke P et al (2006) The standardization of terminology of lower urinary tract functions in children and adolescents: report from the standardization committee of the International children’s continence society (ICCS). J Urol 176(1):314–324

    Article  PubMed  Google Scholar 

  4. Chung JM, Lee SD, Kang DI et al (2009) Korean enuresis association. Prevalence and associated factors of overactive bladder in Korean children 5–13 years old: a nationwide multicenter study. Urology 73(1):63–67

    Article  PubMed  Google Scholar 

  5. Kajiwara M, Inoue K, Kato M et al (2006) Nocturnal enuresis and overactive bladder in children: an epidemiological study. Int J Urol 13:36–41

    Article  PubMed  Google Scholar 

  6. Wallis MC, Khoury AE (2006) Symptom score for lower urinary tract dysfunction in pediatric urology. Curr Urol Rep 7(2):136–142

    Article  PubMed  Google Scholar 

  7. Akbal C, Genc Y, Burgu B et al (2005) Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. J Urol 173:969–973

    Article  PubMed  Google Scholar 

  8. Yildirim A, Uluocak N, Atilgan D et al (2011) Evaluation of lower urinary tract symptoms in children exposed to sexual abuse. Urol J 8(1):38–42

    PubMed  Google Scholar 

  9. Schneider D, Yamamoto A, Barone JG (2011) Evaluation of consistency between physician clinical impression and 3 validated survey instruments for measuring lower urinary tract symptoms in children. J Urol 186(1):261–265

    Article  PubMed  Google Scholar 

  10. Farhat W, Bagli DJ (2000) The dysfunctional voiding scoring system: quantitative standardization of dysfunctional voiding symptoms in children. J Urol 164:1011–1015

    Article  CAS  PubMed  Google Scholar 

  11. Nelson CP, Park JM, Bloom DA et al (2007) Incontinence symptom index and initial validation of a urinary incontinence instrument for the older pediatric population. J Urol 178:1763–1767

    Article  PubMed  Google Scholar 

  12. Fernbach SK, Maizels M, Conway JJ (1993) Ultrasound grading of hydronephrosis: introduction to the system used by the society for fetal urology. Pediatr Radiol 23:478–480

    Article  CAS  PubMed  Google Scholar 

  13. Lebowitz RL, Olbing H, Parkkulainen KV et al (1985) International system of radiographic grading of vesicoureteric reflux. International reflux study in children. Pediatr Radiol 15:105–109

    Article  CAS  PubMed  Google Scholar 

  14. Dik P, Klijn AJ, van Gool JD et al (2006) Early start to therapy preserves kidney function in spina bifida patients. Eur Urol 49:908–913

    Article  PubMed  Google Scholar 

  15. Vande Walle J, Rittig S, Bauer S et al (2012) American academy of pediatrics; European society for paediatric urology, European society for paediatric nephrology; International children’s continence society, practical consensus guidelines for the management of enuresis. Eur J Pediatr 171(6):971–983

    Article  PubMed Central  PubMed  Google Scholar 

  16. Abrams P (2003) Describing bladder storage function: overactive bladder syndrome and detrusor overactivity. Urology 62(5 Suppl 2):28–37

    Article  PubMed  Google Scholar 

  17. Glassberg KI, Combs AJ, Horowitz M (2010) Nonneurogenic voiding disorders in children and adolescents: clinical and videourodynamic findings in 4 specific conditions. J Urol 184(5):2123–2127

    Article  PubMed  Google Scholar 

  18. Pippi Salle JL, Capolicchio G, Houle AM et al (1998) Magnetic resonance imaging in children with voiding dysfunction: is it indicated? J Urol 160(3 Pt 2):1080–1083

    CAS  PubMed  Google Scholar 

  19. Arikan N, Soygür T, Selçuki M et al (1999) Role of magnetic resonance imaging in children with voiding dysfunction: retrospective analysis of 81 patients. Urology 54(1):157–160

    Article  CAS  PubMed  Google Scholar 

  20. Neveus T, Lackgren G, Tuvemo T et al (2000) Enuresis-background and treatment. Scand J Urol Nephrol Suppl 206:1–44

    PubMed  Google Scholar 

  21. Milsom I, Abrams P, Cardozo L et al (2001) How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int 87:760–766

    Article  CAS  PubMed  Google Scholar 

  22. Snodgrass W (1998) The impact of treated dysfunctional voiding on the nonsurgical management of vesicoureteral reflux. J Urol 160:1823–1825

    Article  CAS  PubMed  Google Scholar 

  23. van Gool JD, Hjalmas K, Tamminen-Mobius T et al (1992) Historical clues to the complex of dysfunctional voiding, urinary tract infection and vesicoureteral reflux. The International reflux study in children. J Urol 148:1699–1702

    PubMed  Google Scholar 

  24. Homayoon K, Chen JJ, Cummings JM et al (2005) Voiding dysfunction: outcome in infants with congenital vesicoureteral reflux. Urology 66:1091–1094

    Article  PubMed  Google Scholar 

  25. Koff SA (1992) Relationship between dysfunctional voiding and reflux. J Urol 148:1703–1705

    CAS  PubMed  Google Scholar 

  26. Yeung CK, Sreedhar B, Sihoe JD et al (2006) Renal and bladder functional status at diagnosis as predictive factors for the outcome of primary vesicoureteral reflux in children. J Urol 176:1152–1156

    Article  CAS  PubMed  Google Scholar 

  27. Godley ML, Desai D, Yeung CK et al (2001) The relationship between early renal status and the resolution of vesico-ureteric reflux and bladder function at 16 months. BJU Int 87:457–462

    Article  CAS  PubMed  Google Scholar 

  28. Soygur T, Arikan N, Tokatli Z et al (2004) The role of video-urodynamics studies in managing non-neurogenic voiding dysfunction in children. BJU Int 93:841–843

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Pediatric Urology Division, Department of Urology, Marmara University School of Medicine, Istanbul, Turkey

    Cem Akbal, Ahmet Şahan, T. Emre Şener, Bahadır Şahin, Ilker Tinay, Tufan Tarcan & Ferruh Şimşek

  2. Üroloji AD, Kat:4, Fevzi Çakmak Mah. Mimar Sinan Cad, Marmara Üniversitesi Eğitim ve Araştırma Hastanesi, 34899, Pendik, Istanbul, Turkey

    Cem Akbal

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  1. Cem Akbal
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  2. Ahmet Şahan
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Correspondence to Cem Akbal.

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Akbal, C., Şahan, A., Şener, T.E. et al. Diagnostic value of the pediatric lower urinary tract symptom score in children with overactive bladder. World J Urol 32, 201–208 (2014). https://doi.org/10.1007/s00345-013-1224-y

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  • DOI: https://doi.org/10.1007/s00345-013-1224-y

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