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Published on: December 7, 2018
Urodynamic characterization in children with lower urinary tract symptoms and comorbid ADHD: a retrospective matched
Ping Bai1,2, Lili Liu1,2, Diyi Luo1,2
1Department of Pediatric Urinary Disease Center Nursing, West China Second University Hospital, Sichuan University, Chengdu, China.
Insights
Children with attention-deficit/hyperactivity disorder (ADHD) show significant bladder issues, including reduced capacity and increased detrusor overactivity (DO). These findings highlight the link between ADHD and pediatric lower urinary tract symptoms (LUTS).
Area of Science:
- Pediatric Urology
- Neurodevelopmental Disorders
- Urodynamics
Background:
- Lower urinary tract symptoms (LUTS) are common in children and impact quality of life.
- Attention-deficit/hyperactivity disorder (ADHD) is linked to an increased risk of LUTS in children.
- Limited research exists on the relationship between ADHD and urodynamic characteristics in pediatric LUTS.
Purpose of the Study:
- To evaluate the association between ADHD and urodynamic features in children experiencing LUTS.
- To compare urodynamic parameters between children with and without ADHD.
Main Methods:
- Retrospective case-control study of 144 children with LUTS (36 with ADHD).
- Standardized urodynamic testing including bladder capacity, detrusor pressure, and detrusor overactivity (DO) assessment.
- Multivariable regression analysis to identify independent predictors of urodynamic abnormalities.
Main Results:
- Children with ADHD had significantly reduced bladder volumes at first urge, strong urge, and maximum cystometric capacity compared to controls.
- The ADHD group showed significantly higher detrusor pressure at maximum filling and a greater prevalence of DO.
- Detrusor overactivity (DO) was identified as an independent predictor of urodynamic abnormalities in children with ADHD.
Conclusions:
- Children with ADHD exhibit significant functional bladder abnormalities, including reduced capacity and increased detrusor pressure and activity.
- Neurobehavioral mechanisms may underlie the influence of ADHD on bladder function.
- Findings suggest the importance of early screening and intervention for LUTS in children with ADHD.
Background:
Lower urinary tract symptoms (LUTS) are common functional urinary disorders in children and can markedly impair quality of life. Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition, and emerging evidence suggests that affected children are at increased risk of LUTS. Nevertheless, systematic investigations into the relationship between ADHD and urodynamic characteristics in pediatric LUTS remain limited. This study aimed to evaluate the association between ADHD and urodynamic features in children with LUTS using a case-control design.
Methods:
We conducted a retrospective case-control study including 144 children with LUTS, of whom 36 were diagnosed with ADHD. All participants underwent standardized urodynamic testing, with assessments of bladder capacity, detrusor pressure at maximum filling, and detrusor overactivity (DO). Children were categorized into ADHD and non-ADHD groups, and intergroup comparisons of urodynamic parameters were performed. Multivariable regression analysis was used to assess the independent association between ADHD and urodynamic abnormalities.
Results:
Compared with the non-ADHD group (n = 108), children with ADHD (n = 36) exhibited significantly reduced volumes at first urge, strong urge, and maximum cystometric capacity (all p < 0.05). Conversely, detrusor pressure at maximum filling and the prevalence of DO were significantly higher in the ADHD group (both p < 0.05). Multivariable regression analysis identified DO as an independent predictor of urodynamic abnormalities in children with ADHD (OR = 3.43, 95% CI: 1.32-8.91, p = 0.012).
Conclusions:
Children with ADHD display significant functional bladder abnormalities on urodynamic testing, particularly reduced bladder capacity, increased detrusor pressure during filling, and heightened detrusor activity. ADHD may influence bladder function, at least in part, through neurobehavioral mechanisms. These findings provide valuable clinical insights for the management of LUTS in children with ADHD and underscore the importance of early screening and intervention. Further research is needed to elucidate the underlying mechanisms and to develop effective therapeutic strategies.
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