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Dysfunctional Voiding: Exploring Disease Transition From Childhood to Adulthood.
Frank-Jan van Geen1, Eline H M van de Wetering2, Anka J Nieuwhof-Leppink3
1Department of Urology, UMC Utrecht, Utrecht, The Netherlands.
Urology
|April 7, 2023
Summary
Childhood dysfunctional voiding (DV) often persists into adulthood, with 40% of females retaining DV, 56% experiencing daytime urinary incontinence (DUI), and 28% reporting urinary tract infections (UTIs). These findings highlight the need for improved transitional care.
Area of Science:
- Urology
- Pediatric Urology
- Female Urology
Background:
- Childhood dysfunctional voiding (DV) is common in both pediatric and adult populations.
- The long-term progression of childhood DV into adulthood remains poorly understood.
- Treatment approaches for DV often differ significantly across age groups.
Purpose of the Study:
- To investigate the long-term outcomes of childhood dysfunctional voiding (DV) into adulthood.
- To determine the prevalence of persistent DV, urinary tract infections (UTIs), and daytime urinary incontinence (DUI) in adult females with a history of childhood DV.
- To inform improved transitional care strategies for patients with a history of childhood DV.
Main Methods:
- A cross-sectional follow-up study was conducted on a cohort of 123 females treated for childhood DV between 2000 and 2003.
- Participants were assessed for persistent or recurrent DV using International Continence Society (ICS) criteria, focusing on urinary flow patterns (staccato or intermittent).
- Comparison was made with a control group of healthy women regarding urinary flow patterns, UTIs, and DUI.
Main Results:
- Twenty-five patients participated in the follow-up, with a mean of 20.8 years post-urotherapy.
- 40% of adult females exhibited a staccato or interrupted urinary flow pattern, indicative of persistent DV, compared to 10.6% in the control group.
- Among those with dysfunctional flow, 50% reported UTIs and 50% experienced DUI; 60% of those with normal flow reported DUI, impacting quality of life.
Conclusions:
- Approximately 40% of females treated for childhood DV continue to have DV as adults, according to ICS criteria.
- A significant proportion of these women (56%) still experience daytime urinary incontinence (DUI), and 28% report recurrent urinary tract infections (UTIs).
- These findings underscore the importance of considering long-term DV sequelae in patient counseling and during the transition to adult care.
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