1
|
Abdovic S, Cuk M, Hizar I, Milosevic M, Jerkovic A, Saraga M. Pretreatment morning urine osmolality and oral desmopressin lyophilisate treatment outcome in patients with primary monosymptomatic enuresis. Int Urol Nephrol 2021; 53:1529-1534. [PMID: 33774753 DOI: 10.1007/s11255-021-02843-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the association between urine osmolality (Uosm) in patients with primary monosymptomatic enuresis (PMNE) and response to desmopressin (dDAVP) lyophilisate. METHODS This was a prospective cohort study that included 419 children with enuresis seen in outpatient clinic between October 2017 and October 2019. Patient workup included symptom checklist, 48 h frequency/volume chart, kidney and bladder ultrasound, uroflow, urinalysis and culture, spot urine Ca/creatinine, and first-morning Uosm. Patients < 5 years, with secondary enuresis, or loss of follow-up were excluded. Oral dDAVP lyophilisate was recommended to all with PMNE and normal bladder capacity. After 1 month of therapy, initial success was assessed according to ICCS. Significant predictor variables for complete response were identified and analyzed using correlation coefficients and binary logistic regression. RESULTS There were 48 patients with PMNE who received dDAVP and were followed for treatment success. Partial and complete responses were achieved for 14 (29.2%) and 20 cases (41.7%), respectively. Older age and lower Uosm were found to be significantly in favor of complete response to dDAVP lyophilisate, P = 0.007 and 0.033, respectively. ROC analysis determined the Uosm of ≤ 814 mOsm/kg as a cut-off value for complete success (sensitivity 65% and specificity 75%, AUC = 68.2%). The odds ratio for complete success for selected cut-off value was 5.57 (95% CI 1.588-19.551, P = 0.007). CONCLUSION High pretreatment morning Uosm (> 814 mOsm/kg) might be suggestive of an alternative treatment to dDAVP lyophilisate in PMNE because of the higher risk of treatment failure.
Collapse
Affiliation(s)
- S Abdovic
- Department of Pediatric Nephrology, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia.
| | - M Cuk
- Department of Pediatric Nephrology, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia
| | - I Hizar
- Department of Pediatric Nephrology, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia
| | - M Milosevic
- Andrija Stampar School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia
| | - A Jerkovic
- Department of Pediatric Nephrology, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia
| | - M Saraga
- Department of Pediatric Nephrology, University Hospital Center Split, Split, Croatia
- School of Medicine, University of Split, Split, Croatia
| |
Collapse
|
2
|
Assessment of pediatric bowel and bladder dysfunction: a critical appraisal of the literature. J Pediatr Urol 2018; 14:494-501. [PMID: 30297226 PMCID: PMC6295280 DOI: 10.1016/j.jpurol.2018.08.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/07/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Bowel and bladder dysfunction (BBD) is a clinical syndrome defined by the coexistence of constipation and lower urinary tract symptoms. Although BBD is a common condition in pediatric urology and can cause significant stress to patients/parents, clinical diagnosis of BBD has not been standardized. Bowel and bladder dysfunction instruments have gained popularity over the past decade to aid in diagnosis. In this review, the currently published BBD symptom questionnaires were summarized and an analysis on their psychometric validation process was provided. SUBJECTS/PATIENTS PubMed was searched for articles on BBD symptom questionnaires/instruments/surveys since 2000. Two investigators (R.Y.J. & M.S.K.) conducted the search in duplicate. The search was limited to English language. The included search terms were 'dysfunctional elimination syndrome', 'bowel and bladder dysfunction', 'dysfunctional voiding', 'voiding dysfunction symptom score', and 'dysfunctional voiding symptom scale'. Reference lists of included studies were screened for missed studies. Unpublished abstracts presented at the following scientific meetings were also manually searched for: the American Urological Association, the Society for Pediatric Urology, and the American Academy of Pediatrics Section on Urology. Exclusion criteria included articles in languages other than English, articles not related to BBD questionnaires, and articles not pertaining to pediatric patients. RESULTS After initial search, a total of 54 articles were obtained. Of the seven questionnaires reviewed, only one did not measure sensitivity or specificity. Almost all questionnaires showed excellent discriminative property with an Area under the curve (AUC) >0.85. Criterion validity was not reported in any of the questionnaires. Known-group validation was used as a common method to evaluate construct validity. Internal consistency was reported in 2 studies, and only 1 study measured questionnaire responsiveness during initial validation. CONCLUSIONS Although BBD is a common pediatric urology condition; a large amount of heterogeneity exists in the questionnaires' psychometric testing and validation process. To further improve the diagnosis and management of BBD in pediatric patients, there is a need for consensus on the gold standard questionnaire measure.
Collapse
|
3
|
Chase J, Bower W, Gibb S, Schaeffer A, von Gontard A. Diagnostic scores, questionnaires, quality of life, and outcome measures in pediatric continence: A review of available tools from the International Children's Continence Society. J Pediatr Urol 2018; 14:98-107. [PMID: 29429829 DOI: 10.1016/j.jpurol.2017.12.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/03/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE We reviewed and collated information concerning the available tools for the measurement of symptoms and outcomes in pediatric continence. MATERIALS AND METHODS MEDLINE, EMBASE, and CINHAL databases were searched for relevant articles published prior to December 2016 and independently screened by two researchers. Expert opinion was also widely sought through consultation with the ICCS Board membership and their professional networks and the multidisciplinary authorship group. The most relevant materials were then selected for analysis and inclusion and resulted in a document available on the ICCS website for all members to review. Insights and feedback were considered with consensus and agreement reached to modify the document. RESULTS AND CONCLUSIONS A variety of useful tools for the assessment and measurement of bladder and bowel dysfunction and quality of life and behavioral comorbidities are presented together with their indications and potential pitfalls. ICCS cannot recommend one over another as the most useful for each clinician will vary depending on the clinical setting, available time, and patient population. We provide a framework for choosing those that are most appropriate based on our findings.
Collapse
Affiliation(s)
- Janet Chase
- Victorian Children's Continence Clinic, Melbourne, Australia; Paediatric Gastroenterology Victoria, Royal Children's Hospital, Melbourne, Australia.
| | - Wendy Bower
- Department of Medicine and Community Care, Royal Melbourne Hospital, Melbourne, Australia; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia; Faculty of Urogynecology, The University of Ghent, Belgium
| | - Susan Gibb
- Paediatric Gastroenterology Victoria, Royal Children's Hospital, Melbourne, Australia
| | - Anthony Schaeffer
- Pediatric Urology, Health Services Research, University of Utah/Primary Children's Hospital USA
| | - Alexander von Gontard
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany
| |
Collapse
|
4
|
Altan M, Çitamak B, Bozaci AC, Mammadov E, Doğan HS, Tekgül S. Is There Any Difference Between Questionnaires on Pediatric Lower Urinary Tract Dysfunction? Urology 2017; 103:204-208. [DOI: 10.1016/j.urology.2016.12.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/26/2016] [Accepted: 12/28/2016] [Indexed: 10/20/2022]
|
5
|
Lower Urinary Tract Terminology in Daytime Lower Urinary Tract Symptoms in Children: A View of the Pediatric Urologist. Eur Urol Focus 2017; 3:189-197. [DOI: 10.1016/j.euf.2017.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 09/11/2017] [Accepted: 09/15/2017] [Indexed: 11/20/2022]
|
6
|
Goknar N, Oktem F, Demir AD, Vehapoglu A, Silay MS. Comparison of Two Validated Voiding Questionnaires and Clinical Impression in Children With Lower Urinary Tract Symptoms: ICIQ-CLUTS Versus Akbal Survey. Urology 2016; 94:214-7. [DOI: 10.1016/j.urology.2016.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 03/01/2016] [Accepted: 05/03/2016] [Indexed: 11/26/2022]
|
7
|
Yüksel S, Yurdakul AÇ, Zencir M, Çördük N. Evaluation of lower urinary tract dysfunction in Turkish primary schoolchildren: an epidemiological study. J Pediatr Urol 2014; 10:1181-6. [PMID: 25001292 DOI: 10.1016/j.jpurol.2014.05.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 05/07/2014] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The aim was to determine the prevalence of voiding dysfunction and its related risk factors in Turkish schoolchildren. MATERIALS AND METHODS A randomly selected, cross-sectional study was conducted using a self-administered and previously validated questionnaire. The questionnaire consisted of two parts. The first part included personal demographic and familial information, and the second part included the Dysfunctional Voiding and Incontinence Scoring System (DVISS). The questionnaires were given to 4668 children between 6 and 15 years of age, which were completed by the parents and children together. The children with a score of ≥9 were accepted as having lower urinary tract dysfunction (LUTD). RESULTS The data were collected from 4016 children (the response rate was 86.0%), including 48.6% boys and 51.4% girls. The mean age was 10.5±2.2 years. The overall frequency of LUTD was 9.3%. While the 6-year-old children had the highest frequency (23.1%) of LUTD, this rate was 7.9% at the age of 10, and the children aged 14 years had the lowest frequency (4.9%), (p<0.001). Lower urinary tract symptoms were significantly more common in girls (7.6%) than in boys (3.2%) only for the older age group (between 12 and 15 years of age). Compared with normal children, those with LUTD (with a score of ≥9) had the following risk factors: less educated parents, a parent that had lower urinary tract symptoms when he or she was a child, more persons per room (≥2 persons), more siblings (≥4 siblings) at home, past medical history of urinary tract infections, and squatting position (in girls). CONCLUSIONS Lower urinary tract problems are one of the most important and ongoing health problems in childhood. Determining the prevalence of lower urinary tract problems in children and their related risk factors is the first step to managing and reducing the number of children suffering from voiding problems.
Collapse
Affiliation(s)
- Selçuk Yüksel
- Department of Pediatric Nephrology, Pamukkale University School of Medicine, Denizli, Turkey.
| | - Ayşe Çolpan Yurdakul
- Department of Pediatric Nephrology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Mehmet Zencir
- Department of Public Health, Pamukkale University School of Medicine, Denizli, Turkey
| | - Nergül Çördük
- Department of Pediatric Surgery, Pamukkale University School of Medicine, Denizli, Turkey
| |
Collapse
|
8
|
Zhao PT, Velez D, Faiena I, Creenan EM, Barone JG. Bullying has a potential role in pediatric lower urinary tract symptoms. J Urol 2014; 193:1743-8. [PMID: 25304083 DOI: 10.1016/j.juro.2014.08.123] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2014] [Indexed: 11/27/2022]
Abstract
PURPOSE National statistics estimate that a quarter of American school children are regularly bullied, making this issue the main parental concern and the leading form of school violence. To our knowledge no study in the literature has examined the association of bullying with lower urinary tract symptoms. We evaluated the relationship between being bullied and lower urinary tract symptoms in the pediatric population. MATERIALS AND METHODS We accrued 100 patients from a pediatric urology practice in prospective case-control fashion. The degree of lower urinary tract symptoms was determined by the voiding severity score obtained by a single pediatric urologist. Using the Peer Relations Questionnaire and a thermometer scale we surveyed participants for evidence of victimization from bullying and school related anxiety. We then correlated voiding symptom severity with the degree of bullying. RESULTS After applying our study exclusion criteria we examined and analyzed data on 38 control children without lower urinary tract symptoms and on 38 children with lower urinary tract symptoms. Mean age was similar in the 2 groups. There were more females in the group with lower urinary tract symptoms (22 vs 13). Mean case voiding severity score was 3.82 (range 2 to 5). As measured by Bullied Index Score the degree of being bullied was significantly higher in the case group (4.76 vs 1.95, p <0.001), as was the anxiety level estimated by the thermometer score (3.68 vs 0.97, p <0.001). We also found that physical forms of bullying accounted for worse voiding severity scores (4.56 vs 3.67, p <0.01). CONCLUSIONS To our knowledge our study is the first to show that 1) bullying is significantly associated with pediatric lower urinary tract symptoms and 2) physical forms of bullying accompany worsened symptoms.
Collapse
Affiliation(s)
- Philip T Zhao
- Division of Urology, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
| | - Danielle Velez
- Division of Urology, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Izak Faiena
- Division of Urology, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Eileen M Creenan
- Division of Urology, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Joseph G Barone
- Bristol-Myers Squibb Children's Hospital at Robert Wood Johnson University Hospital, New Brunswick, New Jersey
| |
Collapse
|
9
|
Berry A, Rudick K, Richter M, Zderic S. Objective versus subjective outcome measures of biofeedback: what really matters? J Pediatr Urol 2014; 10:620-6. [PMID: 25070936 DOI: 10.1016/j.jpurol.2014.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 06/04/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Clinical epidemiologic studies suggest that once established, voiding dysfunction can become a lifelong condition if not treated correctly early on in life. Biofeedback is one component of a voiding retraining program to help children with voiding dysfunction. Our goal was to compare objective non-invasive urodynamic data obtained during office biofeedback sessions with patient reported voiding symptom scores. METHODS Charts of 55 children referred in 2010 for pelvic floor muscle biofeedback therapy for urinary incontinence were retrospectively reviewed. Patients with any anatomic diagnoses were excluded. Forty-seven (86%) females and eight males (14%) with a mean age of 8.2 years made up the cohort. Uroflow curves, voided volumes, and post-void residuals were recorded at each visit and served as objective data. Volumes were normalized as a percentage of expected bladder capacity according to age. The patient reported symptom score and patient reported outcome (improved, no change or worse) served as subjective measures of intervention. RESULTS The primary referral diagnoses were day and night wetting in 37 (67%) and daytime incontinence in 18 (33%) children. A history of urinary tract infection (UTI) was noted in 32 (64%) patients, and 25% were maintained on antibiotic prophylaxis during the study period. Twenty-nine percent were maintained on anticholinergic medication. Patients attended an average of 2.5 biofeedback sessions. Voided volumes and post void residual volumes were unchanged, 50% of the abnormal uroflow curves normalized over the course of treatment (p < 0.05). Patient reported symptom score decreased from 12.8 ± 5.6 to 8.0 ± 6.5 (p < 0.002) over an average follow-up time of 276 days reflecting fewer daytime voiding symptoms. There was no significant change in the patient symptom score component for the night-time wetting. Patient-reported outcomes at the final session of biofeedback were rated an improved in 26 (47%), no change in 15 (27%), worse in three (5%) patients, and not rated in 11 patients (21%). CONCLUSIONS Pelvic floor muscle biofeedback is associated with patient-reported improvement in symptoms, reduction in voiding symptom score, and normalization of uroflow curves, but these improvements are not correlated with objective parameters of voided volumes and post-void residual urine obtained during office visits for biofeedback. It is important to identify the most relevant outcome measures for BFB, as insurance coverage for medical interventions that cannot offer outcomes analysis that demonstrates a benefit for the patient will eventually be eliminated.
Collapse
Affiliation(s)
- Amanda Berry
- Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Kristen Rudick
- Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Meg Richter
- Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Stephen Zderic
- Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| |
Collapse
|
10
|
Imamura M, Usui T, Johnin K, Yoshimura K, Farhat W, Kanematsu A, Ogawa O. [Cross-cultural validated adaptation of dysfunctional voiding symptom score (DVSS) to Japanese language and cognitive linguistics in questionnaire for pediatric patients]. Nihon Hinyokika Gakkai Zasshi 2014; 105:112-121. [PMID: 25158553 DOI: 10.5980/jpnjurol.105.112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Validated questionnaire for evaluation of pediatric lower urinary tract symptoms (LUTS) is of a great need. We performed cross-cultural validated adaptation of Dysfunctional Voiding Symptom Score (DVSS) to Japanese language, and assessed whether children understand and respond to questionnaire correctly, using cognitive linguistic approach. METHODS We translated DVSS into two Japanese versions according to a standard validation methodology: translation, synthesis, back-translation, expert review, and pre-testing. One version was written in adult language for parents, and the other was written in child language for children. Pre-testing was done with 5 to 15-year-old patients visiting us, having normal intelligence. A specialist in cognitive linguistics observed the response by children and parents to DVSS as an interviewer. When a child could not understand a question without adding or paraphrasing the question by the parents, it was defined as 'misidentification'. RESULTS We performed pretesting with 2 trial versions of DVSS before having the final version. The pre-testing for the first trial version was done for 32 patients (male to female ratio was 19 : 13). The pre-testing for the second trial version was done for 11 patients (male to female ratio was 8 : 3). In DVSS in child language, misidentification was consistently observed for representation of time or frequency. We completed the formal validated translation by amending the problems raised in the pre-testing. CONCLUSION The cross-cultural validated adaptation of DVSS to child and adult Japanese was completed. Since temporal perception is not fully developed in children, caution should be taken for using the terms related with time or frequency in the questionnaires for children.
Collapse
|
11
|
Akbal C, Şahan A, Şener TE, Şahin B, Tinay I, Tarcan T, Şimşek F. Diagnostic value of the pediatric lower urinary tract symptom score in children with overactive bladder. World J Urol 2013; 32:201-8. [PMID: 24362911 DOI: 10.1007/s00345-013-1224-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 12/05/2013] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aims were (1) to assess the pediatric lower urinary tract symptom score (SS) prior to treatment as a means of determining severity of overactive bladder (OAB) and (2) to investigate relationships between SS results and those of standard diagnostic modalities. MATERIALS AND METHODS Symptom scores were recorded pre- and 6 months SS for 294 children with OAB unrelated to neurological disorder. Uroflowmetry-electromyography data, total bladder capacity, and a 2-day bladder diary were also recorded, and upper urinary tract deterioration was investigated as indicated. Overactive bladder was treated with standard approaches. No response to treatment was defined as 0-49% reduction in OAB-related symptoms based on SS results. Non-responders underwent additional evaluations as indicated. RESULTS Two hundred forty-one patients (97%; mean age 9.8 ± 2.8 years; mean follow-up 11 months; range 6-18 months) completed the study. One hundred thirteen (47%) required ultrasonography (USG), and those with abnormal USG had a significantly higher pre- and 6 months SS (p = 0.016). All non-responders (n = 38; 16%) underwent urodynamics evaluation, 34 underwent spinal magnetic resonance imaging (MRI), 34 underwent voiding cystourethrography (VCUG), and 34 underwent dimercaptosuccinic acid scanning (DMSA). Non-responders with terminal detrusor hyperactivity had significantly lower SS after therapy (p = 0.09). Non-responders with abnormal MRI had higher pre- and 6 months SS than those with normal MRI. Thirteen (38%) of the non-responders who required VCUG had vesicoureteral reflux (VUR), and this subgroup had higher pre-treatment SS (p = 0.030). Seven (21%) of the non-responders who required DMSA had scarring, and all 7 had VUR. The subgroup with scarring had higher pre-treatment SS (p = 0.030). CONCLUSION Pediatric OAB patients with high 6 months SS have a higher incidence of additional upper urinary tract pathology. Those with low pre-treatment SS require fewer laboratory tests and other assessments. The SS tool can reduce the number of urodynamics evaluations, and other tests required to diagnose renal damage in children with OAB.
Collapse
Affiliation(s)
- Cem Akbal
- Pediatric Urology Division, Department of Urology, Marmara University School of Medicine, Istanbul, Turkey,
| | | | | | | | | | | | | |
Collapse
|
12
|
Urinary dysfunction in children is associated with exposure to environmental tobacco smoke. J Pediatr Urol 2013; 9:1116-21. [PMID: 23702349 DOI: 10.1016/j.jpurol.2013.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 04/03/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Environmental tobacco smoke (ETS) is known to cause significant morbidity across a wide variety of organ systems. The purpose of this study was to examine the relationship of ETS exposure with pediatric urinary dysfunction. PATIENTS AND METHODS Participants were drawn from a university-based pediatric urology practice throughout the first half of 2011. All patients who presented with a chief complaint of urinary dysfunction were approached to participate (N = 184). Exclusion criteria eliminated all but 71 subjects. Of these, 68 subjects and their parents completed age-appropriate questionnaires on ETS exposure and symptom severity. Data were analyzed using descriptive statistics and relationship between exposure and outcome was evaluated via Spearman correlation analysis. RESULTS A total of 68 children with no known etiology for their urinary dysfunction were evaluated for symptom severity and ETS exposure. Participants demonstrated a significant positive correlation (rho = 0.592 for those 4-10 years; rho = 0.415 for those 11-17 years) between ETS exposure and severity of their urinary symptoms. CONCLUSIONS These data indicate a positive relationship between ETS exposure and urinary dysfunction among children with no other obvious etiology for their symptoms. Physicians should inform parents of the potential dangers of childhood ETS exposure, including the possible relationship with urinary dysfunction.
Collapse
|
13
|
Drzewiecki BA, Thomas JC, Pope JC, Adams MC, Brock JW, Tanaka ST. Use of Validated Bladder/Bowel Dysfunction Questionnaire in the Clinical Pediatric Urology Setting. J Urol 2012; 188:1578-83. [DOI: 10.1016/j.juro.2012.02.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Indexed: 12/31/2022]
Affiliation(s)
- Beth A. Drzewiecki
- Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - John C. Thomas
- Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - John C. Pope
- Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - Mark C. Adams
- Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - John W. Brock
- Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - Stacy T. Tanaka
- Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| |
Collapse
|