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Risk Factors for the Development of Bladder and Bowel Dysfunction
Thomas W Gaither1, Christopher S Cooper2, Zachary Kornberg1
1Department of Urology, University of California, San Francisco, San Francisco, California; and.
Pediatrics
|December 29, 2017
Summary
Female sex and dilating reflux are key risk factors for bladder and bowel dysfunction (BBD) in children with vesicoureteral reflux. Prophylactic antibiotics and BMI did not significantly impact BBD development in this study.
Area of Science:
- Pediatric Urology
- Pediatric Nephrology
- Pediatric Gastroenterology
Background:
- Patients with vesicoureteral reflux (VUR) and bladder and bowel dysfunction (BBD) face a higher risk of febrile urinary tract infections.
- Previous studies identifying BBD risk factors were retrospective and lacked validated measures.
Purpose of the Study:
- To identify independent risk factors for the development of BBD in children with VUR.
- To analyze the association of sex, BMI, cohort, antibiotic prophylaxis, and reflux status with BBD development.
Main Methods:
- Secondary analysis of data from the Randomized Intervention for Children with Vesicoureteral Reflux and Careful Urinary Tract Infection Evaluation trials.
- Multivariable logistic regression was used to assess the impact of various factors on BBD development, defined by the dysfunctional voiding questionnaire.
Main Results:
- Of 318 patients, 111 (35%) developed BBD. Female sex (aOR=12.7) and dilating reflux (aOR=2.1) were significantly associated with BBD development.
- Baseline BMI percentile and continuous antibiotic prophylaxis were not associated with BBD development.
Conclusions:
- Dilating reflux and being female are significant risk factors for developing BBD in children with VUR.
- BMI and prophylactic antibiotics do not appear to influence BBD development in this population.
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