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A two-day bladder diary for children: Is it enough?

I Lopes1, M L Veiga1, A A N M Braga1

  • 1Center of Voiding Disorders in Children (CEDIMI), Bahiana School of Medicine, Salvador, Bahia, Brazil.

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|September 21, 2015
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Summary

A 2-day bladder diary (BD) is sufficient for evaluating bladder capacity and fluid intake in children with lower urinary tract symptoms (LUTS). While a 2-day BD may miss some frequency issues, it provides comparable results to a 3-day BD.

Keywords:
Bladder diaryChildrenIncontinenceLower urinary tract dysfunctionLower urinary tract symptoms

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Area of Science:

  • Pediatric Urology
  • Urodynamics
  • Lower Urinary Tract Symptoms (LUTS) Evaluation

Background:

  • Bladder diaries (BD) are essential non-invasive tools for assessing lower urinary tract symptoms (LUTS).
  • Current guidelines offer conflicting recommendations on the optimal duration for BD, with some suggesting 2 days and others requiring 3 days for adults.
  • No prior studies have directly compared 2-day and 3-day BDs in pediatric populations.

Purpose of the Study:

  • To determine if a 2-day bladder diary is statistically and clinically comparable to a 3-day bladder diary for pediatric LUTS evaluation.
  • To assess the diagnostic accuracy of a 2-day BD for key parameters like urinary frequency and bladder capacity.

Main Methods:

  • A prospective study involving 92 children (aged 3-16 years) who completed a 3-day voiding diary.
  • Data collected included urination frequency, maximum and average voided volumes (MVV and AVV), and fluid intake.
  • The 2-day BD analysis utilized the first two days of the 3-day diary data.

Main Results:

  • No significant differences were observed between 2-day and 3-day BDs for fluid intake, maximum voided volume, or average voided volume.
  • The 2-day BD demonstrated high sensitivity and specificity for detecting low bladder capacity (97.2% and 90.9%, respectively).
  • For urinary frequency, the 2-day BD showed a sensitivity of 83.4% and a specificity of 91.7%, with an expected 16% false negative rate.

Conclusions:

  • A 2-day bladder diary is a sufficient tool for evaluating bladder capacity and fluid intake in children.
  • While a 2-day BD may result in a small percentage of missed diagnoses for reduced bladder capacity, it offers comparable data to a 3-day diary.
  • The findings support the use of a shorter, 2-day diary to potentially improve parent compliance and simplify the assessment of pediatric LUTS.