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Is there a unique symptom in lower urinary tract dysfunction in children?

Mehmet A Özen1, Mehmet Taşdemir2, Murat S Aygün3

  • 1Department of Pediatric Surgery, Koç University School of Medicine, Istanbul, Turkey.

Lower Urinary Tract Symptoms
|November 2, 2020
PubMed
Summary

Diagnosing pediatric lower urinary tract dysfunction (LUTD) based solely on symptoms like urgency or incontinence can be unreliable. Uroflowmetry/electromyography (UF/EMG) testing is recommended for accurate diagnosis.

Keywords:
childrendysfunctionslower urinary tract symptomsuroflowmetry/electromyography

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Area of Science:

  • Pediatric Urology
  • Urodynamics
  • Child Health

Background:

  • Lower urinary tract symptoms (LUTS) are common in children, with urgency, incontinence, and intermittency frequently observed.
  • Specific symptoms are often presumed to indicate definite diagnoses for lower urinary tract dysfunction (LUTD).

Purpose of the Study:

  • To investigate the relationship between specific LUTD conditions and their associated symptoms in children.
  • To evaluate the diagnostic utility of uroflowmetry/electromyography (UF/EMG) in differentiating LUTD types.

Main Methods:

  • Children were classified into four LUTD categories: overactive bladder (OAB), dysfunctional voiding (DV), underactive bladder, and primary bladder neck dysfunction (PBND) using UF/EMG.
  • Data collected included voiding dysfunction symptom scores, bladder diaries, urinalysis, ultrasonography, and bowel habit history (Rome III criteria).

Main Results:

  • The study included 189 children (106 female); OAB (91 patients) and DV (61 patients) were the most common diagnoses.
  • Constipation and hesitancy were the only symptoms significantly associated with specific LUTD groups (P < .05).
  • Hesitancy was noted in 89.4% of PBND cases, and constipation in 78.6% of DV cases, but other symptoms did not reliably differentiate LUTD types.

Conclusions:

  • There is a generally weak correlation between specific symptoms and LUTD diagnoses in children.
  • A symptoms-based approach may lead to misdiagnosis of LUTD.
  • Focusing on underlying pathologies and utilizing UF/EMG testing is essential for accurate diagnosis.