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Comparative analysis of the symptomatology of children with lower urinary tract dysfunction in relation to objective

Ubirajara Barroso1, Thiago Nova, Anderson Dultra

  • 1Section of Urology, Federal University of Bahia, Salvador, Bahia, Brazil. ubarroso@uol.com.br

International Braz J Urol : Official Journal of the Brazilian Society of Urology
|March 8, 2006
PubMed

Insights

Most children with lower urinary tract dysfunction (LUTD) experience urinary tract infections (UTI) and daily incontinence. Micturition diary and clinical history lack accuracy in diagnosing LUTD symptoms like urgency or coordination issues.

Area of Science:

  • Pediatric Urology
  • Urodynamics
  • Clinical Pediatrics

Background:

  • Lower urinary tract dysfunction (LUTD) is a common condition in children.
  • Understanding the clinical presentation and diagnostic challenges of LUTD is crucial for effective management.

Purpose of the Study:

  • To correlate the clinical presentation of pediatric LUTD with objective urodynamic findings.
  • To evaluate the diagnostic utility of patient history and micturition diaries in identifying LUTD.

Main Methods:

  • Prospective assessment of 44 children with LUTD using questionnaires.
  • Comparison of clinical data with objective measures including micturition diaries and uroflowmetry with electromyography.

Main Results:

  • A history of urinary tract infection (UTI) was present in 70.5% of cases, often with fever.
  • Urinary urgency was universal; daily incontinence affected 75% and nocturnal enuresis 52.3%.
  • Uroflowmetry revealed lack of coordination during micturition in 31.8% of patients, with discrepancies between reported and recorded voiding frequencies.

Conclusions:

  • Previous UTI is common in children with LUTD.
  • Micturition diaries and clinical history show limitations in accurately capturing symptoms like urgency and infrequent voiding.
  • Clinical history alone lacks sufficient sensitivity and specificity for diagnosing detrusor-sphincter dyssynergia in pediatric LUTD.
Abstract

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