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

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.