Maternal anxiety in pediatric urodynamic studies: A prospective analysis of primary and repeated procedures

Invasive urodynamic studies (UDS) can cause significant anxiety in both children and their parents. However, the factors influencing parental anxiety before the primary and repeated UDS remain unclear. This study aimed to assess parental anxiety before pediatric UDS and to identify factors associated with anxiety in both mothers and fathers.

Ethics approval was obtained for this prospective observational study evaluating anxiety levels in children undergoing invasive urodynamic studies (UDS) and their parents at our institution between January 2021 and July 2023. Pre-procedure anxiety was assessed using the Visual Analogue Anxiety Scale (VAS-A) for children and the State-Trait Anxiety Inventory (STAI) for parents. Participants were divided into two groups: primary UDS and repeated UDS. Multivariate analyses were conducted to identify predictors of parental state anxiety.

There were 91 families included in the study. Before the primary UDS, maternal anxiety was significantly higher compared to repeated procedures; in contrast, paternal anxiety did not differ between groups. Maternal state anxiety showed a positive correlation with children's anxiety scores (r = 0.208, p = 0.048), whereas no correlation was observed among fathers. Multivariate analysis indicated that the primary UDS, younger child age, female gender of child, presence of perineal sensation, and lower maternal education level predicted higher maternal anxiety. Only a previous surgery was associated with paternal anxiety.

These findings indicate that maternal anxiety correlates more strongly with the child's emotional response than paternal anxiety. This difference may reflect the closer emotional involvement of mothers in the child's medical care and procedural preparation. Previous procedural experiences might lower maternal anxiety by enhancing familiarity with the procedure.

Maternal anxiety is a prominent component of the distress experienced by parents before pediatric UDS. Targeted counseling focused on mothers and provided before the procedure can improve parental mental well-being and the child's experience during the procedure.