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Urinary tract infection and enuresis in children with chronic functional constipation
Seyed Mohsen Dehghani1, Mitra Basiratnia, Marzieh Matin
1Nephrology Urology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. m_basiratnia@yahoo.com.
Insights
Children with chronic functional constipation frequently experience urinary symptoms, particularly nocturnal enuresis. However, urinary tract infections (UTIs) are uncommon in this group, suggesting enuresis should be considered but UTI screening is not routinely advised.
Area of Science:
- Pediatric Urology
- Gastroenterology
Background:
- Chronic functional constipation is a common pediatric issue with debated links to urinary tract disorders.
- Urinary tract infection (UTI) and enuresis are potential complications, but their prevalence in constipated children requires further investigation.
Purpose of the Study:
- To determine the frequency of urinary tract infections (UTIs) and enuresis in children diagnosed with chronic functional constipation.
Main Methods:
- A cohort of 120 children (60.8% girls) meeting Rome III criteria for chronic functional constipation was studied.
- Detailed medical histories, urinalysis, urine cultures, and abdominal ultrasonography were performed to assess for UTIs and enuresis.
Main Results:
- Nocturnal enuresis affected 22.5% of children, with other urinary symptoms like dysuria also noted.
- Only 5.8% of patients had positive urine cultures, predominantly girls, and urinary tract ultrasounds were normal.
Conclusions:
- While urinary symptoms, especially nocturnal enuresis, are common in children with chronic functional constipation, UTIs are infrequent.
- Nocturnal enuresis warrants consideration in these patients, but routine UTI screening is not recommended.
Introduction:
There is still controversy regarding the possible role of chronic functional constipation in disorders of the urinary tract, specifically urinary tract infection (UTI) and enuresis. The aim of this study was to investigate the frequency of (UTI) and enuresis in children with chronic functional constipation.
Materials And Methods:
We included 120 children (60.8% girls) with chronic functional constipation based on the Rome III criteria. Detailed history of UTI and enuresis or symptoms pointing to these diagnoses was obtained. Urinalysis, urine culture, and abdominal ultrasonography were performed for all of the participants.
Results:
The mean age of the patients was 7.4 ± 3.2 years. Seventy-five percent of the patients had constipation for more than 1 year. The most common urinary symptoms were dysuria (16.7%), urinary frequency (12.5%), and dribbling (4.2%). The frequencies of nocturnal and daytime enuresis were 22.5% and 3.3%, respectively. Pyuria was seen in 10 girls (8.3%). Overall, 7 patients (5.8 %) had a positive urine culture, of whom all were girls and 6 had pyuria. Urinary tract ultrasonography was normal in these patients.
Conclusions:
Urinary symptoms, especially nocturnal enuresis, were found in a significant number of children who had chronic functional constipation, but UTI was not so common in the present study. Therefore, we suggest that nocturnal enuresis be considered in children with chronic functional constipation, but screening for UTI is not recommended in these patients.
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