Related Experiment Video
Updated: Jul 15, 2026
Real-Time Void Spot Assay
Published on: February 10, 2023
Self-reported urinary incontinence, voiding frequency, voided volume and pad-test results: variables in a prospective
An M Bael1, Hildegard Lax, Herbert Hirche
1Department of Paediatric Nephrology, University Hospital Antwerp, Belgium. anbael@attglobal.net
Insights
Self-reported data on childhood urinary incontinence (UI) and voiding habits are often inaccurate. Supervised reporting by a urotherapist is crucial for reliable clinical study outcomes in pediatric UI.
Area of Science:
- Pediatric Urology
- Clinical Research Methodology
- Child Health
Background:
- Functional urinary incontinence (UI) in children, particularly due to urge syndrome or dysfunctional voiding, presents diagnostic challenges.
- Accurate assessment of incontinence, voided volume (VV), and voiding frequency (VF) is essential for treatment evaluation.
Purpose of the Study:
- To assess the congruence between self-reported and objective measures of UI, VV, and VF in children undergoing treatment.
- To evaluate the reliability of questionnaires and voiding diaries in documenting treatment outcomes for pediatric UI.
Main Methods:
- Prospective study involving 202 children in the European Bladder Dysfunction Study (EBDS).
- Collected self-reported data via questionnaires and 72-h voiding diaries pre- and post-treatment.
- Obtained objective data using uroflowmetry and 12-h pad tests, with all data reviewed by a urotherapist.
Main Results:
- Parents under-reported UI in 45% of cases compared to urotherapist scores; 12-h pad test sensitivity was 64%.
- Voiding diaries showed inconsistent entries for UI and VV; VF was inaccurately reported in both questionnaires and diaries.
- While VF decreased and VV increased post-treatment, these changes did not correlate with treatment outcomes.
Conclusions:
- Questionnaires and diaries are useful for screening but not for documenting outcome variables in pediatric UI due to reporting discrepancies.
- Voided volume and voiding frequency lack specificity as outcome measures in children with urge syndrome or dysfunctional voiding.
- The 12-h pad test is insufficiently sensitive for pediatric UI; supervised reporting by a urotherapist is vital for clinical study validity.
Objective:
To determine the congruence between self-reported and objective data on incontinence, voided volume (VV) and voiding frequency (VF), in a prospective study of treatment of functional urinary incontinence (UI) due to urge syndrome or dysfunctional voiding in children.
Patients And Methods:
In all, 202 children, enrolled in the European Bladder Dysfunction Study (EBDS), provided self-reported data on UI, VV and VF, before and after treatment, with validated questionnaires and 72-h voiding diaries. Objective data were obtained with uroflowmetry and a 12-h pad test, also before and after treatment. Questionnaires and diaries were checked and scored by a urotherapist, at scheduled office visits that were combined with uroflowmetry.
Results:
At entry, parents under-reported UI on the questionnaires in 45% of cases, compared with the urotherapist's scores, and the 12-h pad test sensitivity for UI was only 64% (95% confidence interval 55-73%). The voiding diaries had inconsistent entries on UI and on VV. VF was overestimated in the questionnaires and underestimated in the diaries, compared with the urotherapist's scores. A VF of >7/day decreased significantly after EBDS treatment, but with no correlation with treatment outcome. The mean VV increased significantly after treatment for UI, also with no correlation with treatment outcome.
Conclusions:
Voiding diaries and questionnaires are useful tools for charting individual treatment and for screening, but they are ill-suited to documenting outcome variables in urge syndrome or dysfunctional voiding, because of over- and under-reporting. VV and VF lack specificity as outcome variables in children with urge syndrome or dysfunctional voiding. The 12-h pad test is not sensitive enough to complement self-reported symptoms of UI in children with urge syndrome or dysfunctional voiding. Clinical studies on UI rely on complaints and self-reported symptoms, but in children the reporting should be supervised by a trained urotherapist, to provide the necessary checks and balances.
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