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Lower urinary tract dysfunction in children with generalized hypermobility of joints
Laetitia M O de Kort1, John A P M Verhulst, Raoul H H Engelbert
1Department of Pediatric Urology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. l.m.o.dekort@chir.azu.nl
Purpose:
We assessed the relationship between general joint hypermobility (GJH) and lower urinary tract symptoms presenting as nonneurogenic bladder sphincter dysfunction in children.
Materials And Methods:
Parents of 89 children 5 to 12 years old who were diagnosed with GJH according to the Beighton and Bulbena scales were asked to fill out a questionnaire concerning symptoms of nonneurogenic bladder sphincter dysfunction, namely daytime urinary incontinence, nighttime urinary incontinence, urinary tract infection, constipation and fecal soiling. The control group comprised 116 healthy schoolchildren 5 to 12 years old.
Results:
Constipation was reported in 19% of boys with GJH and 4% of male controls (p = 0.02). Fecal soiling occurred more often in the GJH group than in the control group (34% versus 18%, p = 0.07). In girls daytime and nighttime urinary incontinence was more prevalent in the GJH group (38% and 14%, respectively) than in controls (13% and 2%, respectively, p = 0.004 and p = 0.02, respectively). Of girls with GJH 24% had a history of urinary tract infections compared with 11% of the control group (p = 0.08). CONCLUSIONS In children with generalized hypermobility of joints symptoms of nonneurogenic bladder sphincter dysfunction are more prevalent. In boys this condition manifests as constipation and possibly fecal soiling, and in girls as urinary incontinence and possibly urinary tract infections.