The importance of quantitative evaluation of constipation in children with lower urinary tract dysfunction

There is a known association between lower urinary tract dysfunction (LUTD) and constipation. The objective of this study was to investigate any correlation between voiding and bowel symptoms in children with LUTD.

Children presenting with LUTD to our pediatric urology unit were prospectively included. Demographic data were recorded. All patients filled out the "Pediatric Lower Urinary Tract Symptom Score" (P-LUTSS) and "Constipation and Fecal Incontinence Symptom Severity" (CFISS) questionnaires. Symptom score correlation and associations with clinical findings were evaluated.

76 patients were included. The mean P-LUTSS was 11±7.1; mean CFISS was 7.7±7.5. According to P-LUTSS risk groups, median CFISS score increased as the risk group was increased. There was direct correlation between P-LUTSS and CFISS for all patients. 6^th, 7^th, 8^th, 9^th, 10^th and 13^th questions of P-LUTSS were correlated with CFISS; the 1^st and 7^th questions of CFISS were correlated with P-LUTSS. Patients who responded not to have constipation on P-LUTSS had lower CFISS scores compared to those who had constipation. Patients who had a 0 score on CFISS had a mean P-LUTSS of 7.7±6.2, which put the majority of patients in low-risk group. Also, out of these 11 patients, 10 of them responded to have no constipation on P-LUTSS.

A relationship between LUTD and bowel symptoms, as well as the positive correlation between P-LUTSS and CFISS was demonstrated in this study. Patients presenting with LUTD should undergo meticulous evaluation using special questionnaires for bowel symptoms. Only by then, a complete treatment approach can be provided.