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Yang S, Zhou Z, Yang J, Pu Q, Wen Y, Liu X, Zhang Y, Lv L, Hu J, Franco I, Kamperis K, Rittig S, Wang Q, Wen JG. The value of home-uroflowmetry in evaluation of voiding function in children with overactive bladder. J Pediatr Urol 2024:S1477-5131(24)00363-2. [PMID: 39097491 DOI: 10.1016/j.jpurol.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 06/21/2024] [Accepted: 07/10/2024] [Indexed: 08/05/2024]
Abstract
INTRODUCTION Overactive bladder (OAB) in children is clinically common and seriously affects the physical and mental health of children. The voiding frequency (VF) is an important basis for the diagnosis of OAB. The emergence of home-uroflowmetry (HUF) has allowed the patients to record the VF while recording the uroflowmetry at home, and the voiding at home can show the real voiding situation. However, the use of HUF to assess OAB in children and its clinical significance has not been reported in the literature. Thus, this study investigate the value of HUF in evaluation of voiding function in children with OAB and survey the VF of healthy children in Mainland China. MATERIALS AND METHODS From May 2021 to July 2023, 52 children with OAB aged 7-10 years, 48 age-matched volunteers (control group) accepted HUF. Daytime VF and nighttime VF, voided volume (VV) per time, 24-h voided volume (24h-VV), maximum flow rate (Qmax), voiding time (VT), and uroflow pattern were recorded and compute corrected maximum urine flow rate (cQmax). VF in 600 health pupils (7-10 years) from five primary schools in Henan Province China were selected for questionnaire survey by cross-sectional survey and multi-stage sampling methods. RESULTS 52 children with OAB and 48 healthy children completed the available 48-h HUF recordings. 24-hour, daytime, and nighttime VF, and cQmax were higher in the OAB group than in the control group (P < 0.05). However, average VV, Qmax, and VT were lower in the OAB group than in the control group (P < 0.05). There was no significant difference in 24h-VV between two groups (P > 0.05). A total of 502 questionnaires qualified for statistical analysis, and the 24h-VF was 6.3 ± 0.95 times, daytime VF was 5.6 ± 0.89 times, and nighttime VF was 0.7 ± 0.59 times. There was no significant difference in the comparison of 24-h, daytime, and nighttime VF between boys and girls and in the comparison of VF by age (P > 0.05). Compared with the results of the questionnaire, the difference of VF in HUF control group was not statistically significant (P > 0.05). CONCLUSIONS The VF in children is similar to that of adults and the HUF is a useful tool with the ability to more realistically record changes in voiding function in children with OAB.
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Affiliation(s)
- Shuai Yang
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Henan 450052, China; Henan Joint International Paediatric Urodynamic Laboratory, Henan 450052, China
| | - Zhaokai Zhou
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Henan 450052, China; Henan Joint International Paediatric Urodynamic Laboratory, Henan 450052, China
| | - Jing Yang
- The First Affiliated Hospital of Zhengzhou University Surgical Reception Centre, Henan 450052, China
| | - Qingsong Pu
- Henan Joint International Paediatric Urodynamic Laboratory, Henan 450052, China
| | - Yibo Wen
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Henan 450052, China; Henan Joint International Paediatric Urodynamic Laboratory, Henan 450052, China
| | - Xingchen Liu
- Henan Joint International Paediatric Urodynamic Laboratory, Henan 450052, China; Department of Gynecology, Xinyang Central Hospital, Xinyang 464000, Henan, China
| | - Yanping Zhang
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Henan 450052, China; Henan Joint International Paediatric Urodynamic Laboratory, Henan 450052, China
| | - Lei Lv
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Henan 450052, China; Henan Joint International Paediatric Urodynamic Laboratory, Henan 450052, China
| | - Jinhua Hu
- Guangzhou Women and Children's Medical Center, Guangzhou 510000, China
| | - Israel Franco
- Department of Urology, Section of Pediatric Urology, Yale University, New Haven, CT 06520 USA
| | - Konstantinos Kamperis
- Department of Paediatrics and Adolescent Health, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200 Aarhus, Denmark
| | - Søren Rittig
- Department of Paediatrics and Adolescent Health, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200 Aarhus, Denmark
| | - Qingwei Wang
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Henan 450052, China; Henan Joint International Paediatric Urodynamic Laboratory, Henan 450052, China
| | - Jian Guo Wen
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Henan 450052, China; Henan Joint International Paediatric Urodynamic Laboratory, Henan 450052, China.
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da Silva Filho JC, Vieira Santos ICR, Akbal C, Valença MP, Lopes MHBDM, Dos Santos DCM, De Albuquerque LMF. Brazilian Portuguese translation, cross-cultural adaptation, and content validation of the pediatric lower urinary tract symptom score. J Pediatr Nurs 2023; 73:78-83. [PMID: 37651941 DOI: 10.1016/j.pedn.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Early screening instruments for professionals are important to reduce the cost and time of diagnosing pediatric lower urinary tract dysfunction. This study aimed to translate, cross-culturally adapt, and validate pediatric lower urinary tract symptom scores. METHODS This methodological study was conducted in 2019 in two phases: translation and cross-cultural adaptation, and content validation. In the first phase, we used translators, specialists, and 30 parents of children with voiding dysfunction. In the second phase, validation was performed by 11 pediatric urology specialists. FINDINGS The instrument was translated and adapted to Brazilian Portuguese and presented an excellent level of verbal comprehension. Further, the instrument presented a good content validity index >0.8 for all items, except for the nomenclature and clarity of two items, as indicated by the Cronbach's alpha value of 0.75 for internal consistency. DISCUSSION The final version showed semantic, idiomatic, experiential, and conceptual equivalence with the original instrument, indicating that it is adequate for other assessments of psychometric qualities. PRACTICE IMPLICATIONS The translation and adaptation of an important instrument for diagnosing lower urinary tract dysfunction in children to other countries helps nurses identify the disease early and monitor the treatment.
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Affiliation(s)
| | | | - Cem Akbal
- From the Department of Urology, Division of Pediatric Urology, Hacettepe University School of Medicine, Ankara, Turkey
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Bayraktar N, Tekgul S. Delineating the Diagnostic Concordance Between Pediatric Lower Urinary Symptoms Scoring and Voiding Diary in Pediatric Lower Urinary Tract Dysfunction. Cureus 2023; 15:e42463. [PMID: 37502468 PMCID: PMC10368957 DOI: 10.7759/cureus.42463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND This retrospective research endeavored to conduct a comparative evaluation of the Pediatric Lower Urinary Tract Symptoms Scoring (PLUTSS) system and the Voiding Diary (VD). The correlation between these diagnostic tools, their prognostic value for treatment outcomes in pediatric Lower Urinary Tract Dysfunction (LUTD), and their relationship with patients' sociodemographic characteristics were also explored. METHODOLOGY The study data for the cohort established between December 2005 and September 2006 were obtained from a specialized thesis, while the subsequent expansion from 2022 to 2023 involved a prospective approach, including an additional 73 patients, resulting in a total of 113 pediatric patients (79 females and 34 males). Comprehensive diagnostic evaluations, such as urinalysis, urine culture, renal function tests, urinary tract ultrasound, uroflowmetry-electromyography (EMG), and post-voiding residual urine measurement (PVR), were conducted. The patient's symptoms were assessed using the Pediatric Lower Urinary Tract Symptom Score (PLUTSS) and a two-day-three-night voiding diary. RESULTS The correlation between the PLUTSS and VD was not absolute but substantial concerning daytime frequency and incontinence. Notably, PLUTSS emerged as the primary predictor of treatment outcomes. No significant association was discerned between sociodemographic characteristics, such as socioeconomic status, sibling count, toilet training, school performance, patient personality, and LUTD diagnosis or prognosis. CONCLUSION The findings underscore the prognostic value of PLUTSS for treatment outcomes in pediatric LUTD. Although a significant correlation was observed between PLUTSS and VD, they are not interchangeable. As a result, concurrent utilization of both tools is endorsed for comprehensive diagnosis, follow-up, and treatment planning in pediatric LUTD.
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Affiliation(s)
- Necmi Bayraktar
- Urology Department, Dr. Burhan Nalbantoglu State Hospital, Nicosia, CYP
| | - Serdar Tekgul
- Pediatric Urology, Hacettepe University School of Medicne, Ankara, TUR
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Al-Najar A, Al-Nadhari I, Basabih S, Alobathani F, Akbal C. Arabic translation and validation of pediatric lower urinary tract symptom score (PLUTSS). Arab J Urol 2023; 21:40-44. [PMID: 36818374 PMCID: PMC9930764 DOI: 10.1080/2090598x.2022.2108190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Objectives To develop and validate an Arabic version of the pediatric lower urinary tract symptom score (PLUTSS). Methods The linguistic translation of the PLUTSS into Arabic was carried out by following the guidelines that have been set out for cross-cultural adaptation of health-related QoL measures (Translation, Reconciliation, Retranslation, Review of retranslation, Debriefing and final review). The questionnaires were applied to 80 patients, 40 patients seeking urology clinic for lower urinary tract symptoms (LUTS) and 40 patients visiting a pediatric clinic without urological compliant. The discrimination validity and strength of association were tested using Mann-Whitney and chi-square tests. Reliability of translation was tested for internal consistency using the Cronbach's α and ROC Curve was used to evaluate the ability of the questionnaire to discriminate between cases and controls. Results Patients with LUTS had a higher PLUTSS score and QoL score than controls (P < 0.001). The value of Cronbach's alpha of the 13 items (excluding Qol) evaluated on the scale was 0.717 (95% CI: 0.616-0.800). The ROC curve determined the ability of the questionnaire to discriminate between cases and controls where the area under the curve was 0.901 (95% CI: 0.830-0.972). Conclusion The Arabic translated version of the PLUTSS is an acceptable and reliable tool for assessing and evaluating pediatric patients with LUTS in Arabic-speaking countries.
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Affiliation(s)
- Amr Al-Najar
- Faculty of Medical Sciences, Saba University, Sana’a, Yemen,CONTACT Amr Al-Najar Associate Professor of Urology, Saba University, Al-Ansi City, Sana’a, Yemen
| | | | - Sami Basabih
- Department of Urology, Al-Kuwait University Hospital, Sana’a, Yemen
| | - Fawaz Alobathani
- Department of Pediatrics, Al-Kuwait University Hospital, Sana’a, Yemen
| | - Cem Akbal
- Department of Urology, Marmara University School of Medicine, Istanbul, Turkey
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Wagner B, Steiner M, Huber DFX, Crevenna R. The effect of biofeedback interventions on pain, overall symptoms, quality of life and physiological parameters in patients with pelvic pain : A systematic review. Wien Klin Wochenschr 2022; 134:11-48. [PMID: 33751183 PMCID: PMC8825385 DOI: 10.1007/s00508-021-01827-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/29/2021] [Indexed: 12/04/2022]
Abstract
BACKGROUND Biofeedback is recognized as an effective additive method for treating certain phenotypes of chronic pelvic pain syndrome and is a therapeutic option in other pelvic pain conditions. This review aims to evaluate evidence from the literature with a focus on the effect of biofeedback on pain reduction, overall symptom relief, physiological parameters and quality of life. METHODS A systematic literature search was conducted using the databases PubMed, MEDLINE, Embase, Cochrane Library and PEDro from inception to July 2020. Data were tabulated and a narrative synthesis was carried out, since data heterogeneity did not allow a meta-analysis. The PEDro scale and the McMaster Critical Review Form-Quantitative Studies were applied to assess risk of bias. RESULTS Out of 651 studies, 37 quantitative studies of primary research evaluating pelvic pain conditions in male and female adults and children were included. They covered biofeedback interventions on anorectal disorders, chronic prostatitis, female chronic pelvic pain conditions, urologic phenotypes in children and adults and a single study on low back pain. For anorectal disorders, several landmark studies demonstrate the efficacy of biofeedback. For other subtypes of chronic pelvic pain conditions there is tentative evidence that biofeedback-assisted training has a positive effect on pain reduction, overall symptoms relief and quality of life. Certain factors have been identified that might be relevant in improving treatment success. CONCLUSIONS For certain indications, biofeedback has been confirmed to be an effective treatment. For other phenotypes, promising findings should be further investigated in robust and well-designed randomized controlled trials.
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Affiliation(s)
- Barbara Wagner
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Margarete Steiner
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Dominikus Franz Xaver Huber
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Sajith S, Patnaik SK, Kanitkar M. Comparison of a Voiding Diary With Clinical Management Tool As an Outpatient Screening Tool for Childhood Functional Voiding Disorders. Indian Pediatr 2021. [DOI: 10.1007/s13312-021-2397-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tan PSP, Mallitt K, McCarthy HJ, Kennedy SE. The impact of caring for children with posterior urethral valves. Acta Paediatr 2021; 110:1025-1031. [PMID: 32744791 DOI: 10.1111/apa.15516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 11/30/2022]
Abstract
AIM To investigate and describe factors contributing to the impact of caring for a child with posterior urethral valves and to determine the extent to which families view their care as family-centred, and whether this can affect the impact of care. METHODS A cross-sectional, survey-based study involving primary caregivers of children with posterior urethral valves. Caregivers completed the Impact on Family Scale (IOFS) and the Measure of Processes of Care (MPOC). Regression analyses were used to assess the relationship between child-related variables, demographic variables, MPOC and IOFS scores. RESULTS Thirty-one primary caregivers completed both questionnaires. Caregivers of children with moderate/severe chronic kidney disease (CKD) scored higher on the IOFS compared to those caring for children with mild CKD. Caregivers rated care received highly but reported lower scores in subscales related to information provision. Receiving less respectful and supportive care was significantly associated with lower IOFS scores. CONCLUSION The impact of caring for a child with posterior urethral valves is variable and is strongly determined by the severity of the associated CKD. Further research is required to show whether improving family centredness of care can reduce the impact of caring for children with posterior urethral valves.
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Affiliation(s)
- Peony Shih Pui Tan
- School of Women's and Children's Health UNSW Medicine University of New South Wales Sydney NSW Australia
| | - Kylie‐Ann Mallitt
- School of Women's and Children's Health UNSW Medicine University of New South Wales Sydney NSW Australia
- Centre for Big Data Research in Health University of New South Wales Sydney NSW Australia
| | - Hugh J. McCarthy
- School of Women's and Children's Health UNSW Medicine University of New South Wales Sydney NSW Australia
- Department of Nephrology Sydney Children's Hospital Randwick NSW Australia
| | - Sean E. Kennedy
- School of Women's and Children's Health UNSW Medicine University of New South Wales Sydney NSW Australia
- Department of Nephrology Sydney Children's Hospital Randwick NSW Australia
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Ebiloglu T, Kaya E, Köprü B, Topuz B, Irkilata HC, Kibar Y. Biofeedback as a first-line treatment for overactive bladder syndrome refractory to standard urotherapy in children. J Pediatr Urol 2016; 12:290.e1-290.e7. [PMID: 27102986 DOI: 10.1016/j.jpurol.2016.02.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 02/23/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Overactive bladder syndrome (OAB) and dysfunctional voiding (DV) are subgroups of lower urinary tract dysfunction (LUTD). Standard urotherapy is the first-line treatment option of OAB in children. OBJECTIVES The aim was to investigate the use of biofeedback as a first-line treatment option in OAB refractory to standard urotherapy, and determine the factors affecting efficacy. STUDY DESIGN Between 2005 and 2015, we retrospectively analyzed a total of 136 hospital records of children with OAB who had not previously used any anticholinergics and were refractory to standard urotherapy. Patients with urgency and/or urge incontinence and/or making holding maneuvers to suppress urgency were defined as having OAB symptoms, and resolution of these complaints was defined as successful biofeedback therapy. RESULTS Seventy-three of 136 OAB patients' urgency recovered by biofeedback therapy with the success rate of 53% (p < 0.001). Sixty-two of 101 patients with holding maneuvers (success rate 61%) (p < 0.001), 70 of 101 patients with urgency incontinence (success rate 69%) (p < 0.001), 76 of 114 patients with daytime incontinence (success rate 66%) (p = 0.023), 87 of 97 patients with enuresis (success rate 89%) (p = 0.009), and 27 of 39 patients with dysuria (success rate 69%) (p = 0.007) recovered from their symptoms significantly. The mean lower urinary tract symptom score (LUTSS) was 16.38 and 8.18 before and after biofeedback therapies, respectively (p < 0.001) (Table). Patients without holding maneuvers (p = 0.045), daytime incontinence (p = 0.030), and enuresis (p = 0.045) had better recovery compared to the opposites. DISCUSSION Biofeedback can be thought of as the first-line treatment option when standard urotherapy fails in children with OAB.
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Affiliation(s)
- Turgay Ebiloglu
- Etimesgut Military Hospital, Department of Urology, Ankara, Turkey
| | - Engin Kaya
- Gulhane Military Medical Academy, Department of Urology, Ankara, Turkey
| | - Burak Köprü
- Konya Military Hospital, Department of Urology, Konya, Turkey.
| | - Bahadır Topuz
- Gulhane Military Medical Academy, Department of Urology, Ankara, Turkey
| | | | - Yusuf Kibar
- Gulhane Military Medical Academy, Department of Urology, Ankara, Turkey
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Ebiloglu T, Kaya E, Kopru B, Ergin G, Sahin S, Irkilata HC, Kibar Y. Concised Form for Lower Urinary Tract Dysfunction Symptom Scale in Children. J Clin Diagn Res 2016; 10:PC04-6. [PMID: 27630896 DOI: 10.7860/jcdr/2016/19056.8130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 04/27/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Symptom Scales (SS) are questionnaires for evaluating and following up of special illnesses. SS used for the diagnosis and follow-up of Lower Urinary Tract Dysfunction (LUTD) in children is called LUTD Symptom Scale (LUTDSS). AIM Aim of the present study was to identify the questions which are more important for the diagnosis of LUTD in children and create a simpler SS. MATERIALS AND METHODS From January 2005 to March 2015, 631 children between the age 5 and 15 were enrolled in this study. Eleven children with active urinary tract infections were excluded from the study. Two hundred sixty three children from the nursery and secondary school saying that they have no urinary complaints and having LUTDSS <9 were designed as control group. Three hundred fifty seven children with LUTDSS score ≥9 were thought as having LUTD and diagnoses were verified with 3-day bladder diaries and 2-time Uroflow-EMG-PVR tests. The answered questions of LUTDSS in patient and control group were compared. RESULTS Children with daytime incontinence (first question of questionnaire) were 47.7 (4.8-510) times (p=0.01), children with enuresis (third question) were 59.53 (6.2-961) times (p=0.001), children with pause while urinating (eighth question) were 28.7 (4.4-2090) times (p=0.001), children with urgency (tenth question) were 54.7 (29.3-604) times (p=0.039) more likely to have LUTD than the children not having these complaints. The area under ROC curve created by using 1,3,8, and 10 questions was calculated 86.4%. CONCLUSION The diagnosis and control of LUTD can be made by using only 1., 3., 8. and 10. questions, and these 4 questions could form simpler SS for LUTD in children.
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Affiliation(s)
- Turgay Ebiloglu
- Specialist, Deparment of Urology, Etimesgut Military Hospital , Ankara, Turkey
| | - Engin Kaya
- Specialist, Deparment of Urology, Gulhane Military Medical Academy , Ankara, Turkey
| | - Burak Kopru
- Specialist, Deparment of Urology, Konya Military Hospital , Ankara, Turkey
| | - Giray Ergin
- Specialist, Deparment of Urology, Koru Hospital , Ankara, Turkey
| | - Soykan Sahin
- Specialist, Deparment of Public Health, Gulhane Military Medical Academy , Ankara, Turkey
| | - Hasan Cem Irkilata
- Professor, Department of Urology, Gulhane Military Medical Academy , Ankara, Turkey
| | - Yusuf Kibar
- Professor, Department of Urology, Gulhane Military Medical Academy , Ankara, Turkey
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Beksac AT, Koni A, Bozacı AC, Dogan HS, Tekgul S. Postvoidal residual urine is the most significant non-invasive diagnostic test to predict the treatment outcome in children with non-neurogenic lower urinary tract dysfunction. J Pediatr Urol 2016; 12:215.e1-8. [PMID: 27233211 DOI: 10.1016/j.jpurol.2016.04.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Uroflowmetry (UF) alone is often inadequate or unreliable to diagnose lower urinary tract dysfunction (LUTD). Therefore, other non-invasive tests, such as ultrasound (US), post-voiding residual volume (PVR) assessment and symptom scales, are used as well for objective definition of the problem. OBJECTIVE The aim of this study was to investigate the possible predictive function of the non-invasive diagnostic tests for the response to treatment. STUDY DESIGN The prospective registry data of 240 patients with LUTD, from November 2006 to September 2013, were retrospectively analyzed. All patients were aged 5-14 years old. Patients with a previous diagnosis of vesicoureteral reflux (VUR), neurogenic bladder, monosymptomatic nocturnal enuresis (NE) were excluded from the study. Uroflowmetry, US, PVR and the Dysfunctional Voiding and Incontinence Symptom Scale (DVISS) were performed on every patient at their first visit and follow-ups. A DVISS <9 was considered as the DVISS response; parental opinion was based on International Continence Society criteria of clinical response. Time passed until clinical response was the last outcome parameter. RESULTS Mean age was 8.2 years. Median follow-up was 60.5 months. A total of 62% of patients had complete response, 28.1% had partial response, and 9.7% had no response. Demographic variables were not associated with clinical outcome. Co-existing enuresis nocturna, multiple pharmacotherapy, and increased DVISS were associated with longer time until clinical response. Post-voiding residual volume assessment was the only test to have a prognostic value. DISCUSSION Resolution rates of LUTD ranged from 40 to 90%. High resolution rate could be attributed to the long follow-up period, and the chance of spontaneous resolution. Treatment modalities and co-existing NE were associated with longer time until clinical response. Only PVR was associated with prognosis. This was the first study in literature to report such findings. It was seen that the normalization of pathologic patterns was a good sign for treatment success. The DVISS results showed significantly higher rates of incontinence compared to initial symptoms defined by the patients and/or their parents. This showed the importance of using scoring systems to better define the severity of symptoms. It was hard to establish a standardized cut-off value for bladder wall thickness on US. However, US was a good test for diagnosing additional pathologies. CONCLUSION Increased PVR was the single tool that was associated with prognosis and, therefore, should always be performed after UF. In addition, DVISS can help parents be counseled about their treatment expectations.
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Affiliation(s)
- A T Beksac
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey.
| | - A Koni
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
| | - A C Bozacı
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
| | - H S Dogan
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
| | - S Tekgul
- Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey
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Demir AD, Gursoy AE, Goknar N, Uzuner S, Ozkaya E, Erenberk U, Vehapoglu A, Dundaroz MR, Oktem F. Evaluation of autonomic nervous system function in children with overactive bladder syndrome. Neurourol Urodyn 2016; 36:673-676. [PMID: 26999796 DOI: 10.1002/nau.22993] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 02/22/2016] [Indexed: 11/07/2022]
Abstract
PURPOSE We aimed to evaluate the autonomic nervous system activity in children with overactive bladder (OAB) syndrome. METHODS Included in the study were 40 children with overactive bladder and 28 healthy controls. Autonomic tests were performed on all participants, including heart rate interval variation (RRIV), heart rate response to valsalva maneuver, and sympathetic skin response (SSR). RESULTS Mean valsalva rates in the overactive bladder and control groups were 1.53 ± 0.29 and 1.30 ± 0.18, respectively, a statistically significant difference (P < 0.001). Also significantly different were deep breathing RRIV values of the study and control groups: 56.65 ± 14.66 and 47.92 ± 10.15, respectively (P = 0.008). No statistical differences were found in SSR when OAB patients were compared with controls (P > 0.05). CONCLUSIONS This study demonstrated a parasympathetic hyperactivity in children with OAB, results suggesting a dysfunction in their autonomic nervous systems. Neurourol. Urodynam. 36:673-676, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Aysegul Dogan Demir
- Faculty of Medicine, Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Azize Esra Gursoy
- Faculty of Medicine, Department of Neurology, Bezmialem Vakif University, Istanbul, Turkey
| | - Nilufer Goknar
- Faculty of Medicine, Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
| | - Selcuk Uzuner
- Faculty of Medicine, Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Emin Ozkaya
- Faculty of Medicine, Department of Pediatric Allergy and Immunology, Bezmialem Vakif University, Istanbul, Turkey
| | - Ufuk Erenberk
- Faculty of Medicine, Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Aysel Vehapoglu
- Faculty of Medicine, Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Mehmet Rusen Dundaroz
- Faculty of Medicine, Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey
| | - Faruk Oktem
- Faculty of Medicine, Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey
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