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Tiryaki Ö, Menekşe D, Çınar N. The Relationship between video game addiction and bladder/bowel dysfunction in children. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2024; 44:368-378. [PMID: 39241247 PMCID: PMC11466372 DOI: 10.7705/biomedica.7018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/23/2024] [Indexed: 09/08/2024]
Abstract
INTRODUCTION Video games have a strong influence on children and adolescents. Video game addiction has negative effects on children's health. OBJECTIVE To determine the relationship between video game addiction and bladder/bowel dysfunction in children. MATERIALS AND METHODS Three hundred sixty-three children and their mothers who met the inclusion criteria constituted the sample of this correlational study. The data were collected using a descriptive information form, the Video Game Addiction Scale for Children, and the Childhood Bladder and Bowel Dysfunction Questionnaire. RESULTS We found that 72.5% of the children were nine years old and 27.5% were ten years old; 50.4% were males and 49.6% were female. While 4.7% of the children who participated in the study were underweight, 19.6% were overweight, and 17.9% were obese. The mean Video Game Addiction Scale for Children score was 50.77 ± 16.17, whereas the mean Childhood Bladder and Bowel Dysfunction Questionnaire score was 29.98 ± 8.90. The ratio of children with a mean Video Game Addiction Scale for Children scores equal to or greater than 90 was 0.8% (n = 3). We found that 3.6% (n = 13) of the children had urinary/fecal incontinence while playing video games. There was a weak positive relationship between the dimensions of the Video Game Addiction Scale for Children scores, the Childhood Bladder and Bowel Dysfunction Questionnaire scores, and children's bladder and bowel function (r = 0.220; p ˂ 0.05). CONCLUSIONS There is a correlation between children's video game addiction level and their bladder and bowel dysfunction grade. Higher video game addiction levels correspond to higher bladder and bowel dysfunction.
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Affiliation(s)
- Öznur Tiryaki
- Department of Midwifery, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Dilek Menekşe
- Department of Pediatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Nursan Çınar
- Department of Pediatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
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van Engelenburg-van Lonkhuyzen ML, Bols EMJ, Bastiaenen CHG, de Bie RA. Measurement properties of the childhood bladder and bowel dysfunction questionnaire. J Pediatr Gastroenterol Nutr 2024; 78:592-600. [PMID: 38314913 DOI: 10.1002/jpn3.12152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVES The childhood bladder and bowel dysfunction questionnaire (CBBDQ) was previously found feasible, structurally valid, with good internal consistency. The purpose of this study was to evaluate the remaining measurement properties according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). METHODS A prospective cohort study among parents of children aged 5-12 years was conducted. Calculated were the area under the curve (AUC) (criterion validity, responsiveness, interpretability) and intra-class correlation coefficients (ICCagreement ) (construct validity and test-retest reliability). RESULTS One hundred and seventy-two parents were included from March 2019 to April 2021. Correlating the bladder subscales of the CBBDQ with the Vancouver symptom score for dysfunctional elimination (VSSDES) and proxy-reported pediatric incontinence quality of life (p-PinQ) showed convergent validity (ICCsagreement : 0.76 and 0.74). Divergent validity was found when correlating the bowel subscales of the CBBDQ with the VSSDES (ICCagreement : 0.52). Excellent criterion validity (AUC: 0.98); excellent test-retest reliability (ICCagreement : 0.94) and, at 6 months, fair responsiveness (AUC: 0.74) were found. The minimal important change was 4.5, with cut-off value of 11. CONCLUSION The CBBDQ has been developed according to COSMIN standards. The items were defined using the consensus-based ICCS standards and Rome-III criteria. The measurement properties were identified using enough participants. Although interpretability is not considered a measurement property, interpretability aspects are reported here as they refer to what instrument scores mean. The 18-item-CBBDQ met the measurement properties of validity, reliability, and responsiveness, as defined by COSMIN. The CBBDQ is suitable for self-administration by parents, and completion takes little time.
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Affiliation(s)
- Marieke L van Engelenburg-van Lonkhuyzen
- Department of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
- Departmentof Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Esther M J Bols
- Research Group Autonomy and Participation for Persons with a Chronic Illness and Academy of Physiotherapy, Zuyd University, Heerlen, The Netherlands
| | - Caroline H G Bastiaenen
- Department of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
- Departmentof Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Rob A de Bie
- Department of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
- Departmentof Epidemiology, Maastricht University, Maastricht, The Netherlands
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Maagdenberg SJM, Klinkenberg S, Sophie van den Berg J, Altena-Rensen S, Vrijens D, Janssen EJM, Gierenz N, de Wall LL, Braakman HMH. Impact of gastrointestinal and urological symptoms in children with myotonic dystrophy type 1. Neuromuscul Disord 2024; 35:1-7. [PMID: 38184901 DOI: 10.1016/j.nmd.2023.12.011] [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: 07/04/2023] [Revised: 11/29/2023] [Accepted: 12/15/2023] [Indexed: 01/09/2024]
Abstract
Gastrointestinal and urological symptoms are frequently reported by people with myotonic dystrophy type 1 (DM1) but have remained understudied. In a cross-sectional study, frequency, nature, treatment and impact of gastrointestinal and urological symptoms in children with DM1 aged 5-18 years were assessed. We included 58 children (30 males, 28 females) with a mean age of 13 years; 74.1 % reported at least one gastrointestinal symptom. Abdominal pain was the most frequently reported symptom (51.7 %), followed by dysphagia (41.8 %), diarrhoea (36.2 %), encopresis (36.0 %), constipation (32.7 %), bloating and flatulence (both 25.9 %). The most frequently reported urological symptoms were difficulty with toilet training (59.3 %), urinary incontinence (22.0 %), enuresis nocturna (10.3 %) and voiding (23.5 % hesitancy, 4.8 % intermittency and 13.8 % dysuria). The majority considered urological and gastrointestinal symptoms to have a negative influence on their daily life; 22.4 % of parents reported severe influence on daily family life (shame, social restrictions, school absence and concerns for their children's future). Considering the high prevalence of urological and gastrointestinal symptoms in children with DM1 and their influence on daily life it is key to correctly recognize, diagnose and treat these symptoms. We recommend screening for gastrointestinal and urological symptoms in the standard of care for children with DM1.
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Affiliation(s)
- Sandra J M Maagdenberg
- Department of Pediatric Neurology, Amalia Children's Hospital, Radboud University Medical Center, Geert Grooteplein-Zuid 10, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Sylvia Klinkenberg
- Department of Pediatric Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - J Sophie van den Berg
- Department of Pediatric Neurology, Amalia Children's Hospital, Radboud University Medical Center, Geert Grooteplein-Zuid 10, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Sandra Altena-Rensen
- Department of Pediatric Neurology, Amalia Children's Hospital, Radboud University Medical Center, Geert Grooteplein-Zuid 10, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Desiree Vrijens
- Department of Urology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Etienne J M Janssen
- Department of Pediatrics, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Nicole Gierenz
- Department of Pediatric Gastroenterology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Liesbeth L de Wall
- Department of Pediatric Urology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hilde M H Braakman
- Department of Pediatric Neurology, Amalia Children's Hospital, Radboud University Medical Center, Geert Grooteplein-Zuid 10, PO Box 9101, 6500 HB, Nijmegen, the Netherlands.
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Alliot H, Faraj S, Loubersac T, Meurette G, De Napoli Cocci S, Leclair MD. Assessment of Anorectal Function and Related Quality of Life of 27 Patients with Bladder Exstrophy or Epispadias After Kelly Radical Soft Tissue Mobilisation. J Pediatr Surg 2023; 58:2222-2228. [PMID: 37487788 DOI: 10.1016/j.jpedsurg.2023.05.029] [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: 02/12/2023] [Revised: 05/09/2023] [Accepted: 05/29/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION The Radical soft-tissue mobilisation (RSTM) described by J.H. Kelly for bladder exstrophy repair implies a detachment of levator ani muscle insertions from the pelvic wall. The aim of this controlled study was to evaluate the impact of this procedure on subsequent anorectal function. METHODS Monocentric controlled study of prospectively collected data of children who underwent RSTM for BEEC from 2010 to 2017. Patients born after 2017 were not included, as they were below the theoretical age of continence acquisition at the time of the study. Anorectal function was assessed using the Childhood Bladder and Bowel Dysfunction Questionnaire, and quality of life (QoL) related to fecal continence using the CINCY FIS questionnaire. The control group was paired on age and sex with a 1:3 patient/control ratio. Answers to questionnaires were collected from September 2021 to January 2022. Univariate statistical analysis comparing two groups and subgroup analysis following age were also performed. RESULTS During the period of study, 55 children with BEEC underwent Kelly RSTM. Twenty-seven (49%) were included and paired with 81 healthy children on age and sex. Median age at surgery was 15 months [0.5-93] and median follow-up was 10 years [4-13]. Patient's group median age at evaluation was 11 years [5-19]. There was no difference between patients and control group in anorectal function for both incontinence and constipation items. No significant difference was found in QoL related to fecal incontinence assessment. Subgroup analysis did not show difference. CONCLUSION This study suggests that the levator ani detachment during Kelly procedure, realised in a paediatric population under the age of 8, did not impact anorectal function with a mid-term follow-up. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Hortense Alliot
- Pediatric Surgery, Hôpital Mère-Enfant, Centre Hospitalier Universitaire, Nantes, France.
| | - Sébastien Faraj
- Pediatric Surgery, Hôpital Mère-Enfant, Centre Hospitalier Universitaire, Nantes, France
| | - Thomas Loubersac
- Pediatric Surgery, Hôpital Mère-Enfant, Centre Hospitalier Universitaire, Nantes, France
| | | | | | - Marc-David Leclair
- Pediatric Surgery, Hôpital Mère-Enfant, Centre Hospitalier Universitaire, Nantes, France
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Bols E, Beekman E. Clinimetrics: Childhood Bladder and Bowel Dysfunction Questionnaire. J Physiother 2023; 69:193-194. [PMID: 37271694 DOI: 10.1016/j.jphys.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/27/2023] [Indexed: 06/06/2023] Open
Affiliation(s)
- Esther Bols
- Research Centre for Autonomy and Participation of Persons with a Chronic Illness, Zuyd University of Applied Sciences, the Netherlands
| | - Emmylou Beekman
- Research Centre for Autonomy and Participation of Persons with a Chronic Illness, Zuyd University of Applied Sciences, the Netherlands; Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, the Netherlands
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Sommer-Joergensen V, Sarcevic J, Haecker FM, Holland-Cunz S, Gros SJ, Frech-Dörfler M. Dysfunctional Voiding and Incontinence Scoring System for Children and Adolescents: A Tool to Predict Clinical Course and Outcome. Eur J Pediatr Surg 2022; 32:429-434. [PMID: 35114717 DOI: 10.1055/s-0041-1741543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Lower urinary tract symptoms (LUTS) in children are common. In 2005, Akbal et al published the dysfunctional voiding and incontinence scoring system (DVAISS) to assess patient's symptoms. Our study aimed to determine the value of this scoring system for predicting the severity and clinical course of voiding abnormalities in children and adolescents. MATERIAL AND METHODS Patients' symptoms were scored using the DVAISS in children and adolescents with LUTS presenting for the first time to our pediatric urology department between January 2010 and December 2015. We correlated the calculated score with voiding volume, clinical course, and outcome. RESULTS A total of 168 patients (113 boys, 55 girls; age 5-18 years) with isolated LUTS were included. In 53 patients (group 1), the DVAISS score was less than or equal to 8.5 and in the other 115 patients (group 2), the score was greater than 8.5 suggestive for relevant voiding abnormalities. Patients in group 1 showed a significantly higher average voiding volume (200 vs. 110 mL, p = 0.001). The median time for symptom resolution was significantly higher in group 2 than group 1 (14 vs. 8 months; p = 0.018). The severity of LUTS could be determined by these parameters. CONCLUSION Based on the DVAISS, a prediction of the clinical course and approximate treatment duration is possible. Therefore, the DVAISS is useful to assess LUTS in children and is also a valuable tool in rating the severity of the disease. It is also a quite precise predictor of the time needed to resolve the symptoms.
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Affiliation(s)
| | - Jelena Sarcevic
- Department of Pediatric Surgery, University Children's Hospital Basel, Basel, BS, Switzerland
| | - Frank-Martin Haecker
- Department of Pediatric Surgery, University Children's Hospital Basel, Basel, BS, Switzerland.,Department of Pediatric Surgery, Ostschweizer Kinderspital, St Gallen, St Gallen, Switzerland
| | - Stefan Holland-Cunz
- Department of Pediatric Surgery, University Children's Hospital Basel, Basel, BS, Switzerland
| | - Stephanie J Gros
- Department of Pediatric Surgery, University Children's Hospital Basel, Basel, BS, Switzerland
| | - Martina Frech-Dörfler
- Department of Pediatric Surgery, University Children's Hospital Basel, Basel, BS, Switzerland
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Peck B, Terry D, Martin B, Matthews B, Green A. Outcomes of a pilot evaluation of a group urotherapy programme for children with complex elimination disorders: An Australian experience. J Child Health Care 2022; 26:438-447. [PMID: 34038187 DOI: 10.1177/13674935211022537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Evidence-based interventions have continued to show positive effects on both reducing symptoms and helping children with elimination disorders achieve continence and manage troubling psychological distress. Despite this, there is a group of children who do not respond to standard treatments and are classified as having a complex elimination disorder. As a means of addressing the broader clinical challenge and implications of complex elimination disorders, a team of clinicians in Germany developed the Urinary and Faecal Incontinence Training Program for Children and Adolescents. A pilot investigation was undertaken to apply the Urinary and Faecal Incontinence Training Program for Children and Adolescents programme to children aged 6-12 years in an Australian context who met the complex elimination disorder diagnostic criteria, to determine if any subsequent change in the measures of life quality and general well-being was achieved. Findings suggest a reduction in the frequency of the child's symptoms and improvements in family quality of life measures. Qualitatively, children and parents perceived that their child's ability to now respond to stimuli and in so doing avert severe accidents was a major outcome of the programme and was able to increase a child's sense of acceptance of incontinence, improve levels of self-efficacy and increase self-awareness.
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Affiliation(s)
- Blake Peck
- School of Health, 1458Federation University, Ballarat, VIC, Australia
| | - Daniel Terry
- School of Health, 1458Federation University, Ballarat, VIC, Australia
| | - Benita Martin
- 72558Ballarat Health Services, Queen Elizabeth Centre, Grampians Regional Continence Service, Ballarat, VIC, Australia
| | - Belinda Matthews
- 72558Ballarat Health Services, Queen Elizabeth Centre, Grampians Regional Continence Service, Ballarat, VIC, Australia
| | - Andrea Green
- 72558Ballarat Health Services, Queen Elizabeth Centre, Grampians Regional Continence Service, Ballarat, VIC, Australia
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Bernardes RP, Barroso U, Cordeiro DB, Scremim C, Lonkhuyzen MLVEV, de Bie RA. Translation and cross-cultural adaptation of the Childhood Bladder and Bowel Dysfunction Questionnaire (CBBDQ). J Pediatr (Rio J) 2021; 97:540-545. [PMID: 33340462 PMCID: PMC9432152 DOI: 10.1016/j.jped.2020.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To translate and cross-culturally adapt the Childhood Bladder and Bowel Dysfunction Questionnaire (CBBDQ) for use in Brazilian Portuguese. The CBBDQ is an 18-item tool covering 10 bladder and 8 bowel symptoms that was developed for use with children of 5 to 12 years of age with bowel and bladder dysfunction (BBD). The instrument has already been validated for use in Dutch and English. METHOD In the process of translation and cultural adaptation from English to Portuguese, the CBBDQ was submitted to undergo the required steps as established by the international methodological criteria: forward translation, synthesis, back-translation, expert panel review and pre-testing. RESULTS Ninety-three parents of children with lower urinary tract dysfunction answered the questionnaire. The mean age of the children was 7.6±2.1 years and 54 were female. Internal consistency was excellent, with a Cronbach's alpha of 0.91 to 0.96. Additionally, reliability was high, with an intraclass correlation coefficient of 0.94 (95%CI: 0.85-0.93; p<0.0001). CONCLUSION The translation and cultural adaptation of the CBBDQ enabled a quantitative evaluation of bladder and bowel symptoms to be performed in Brazilian children. The scores achieved allow the severity of BBD to be evaluated, as well as the patient's progress during treatment. The use of this questionnaire in clinical practice and research will allow more consistent data on BBD to be obtained.
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Affiliation(s)
- Rejane P Bernardes
- Clínica Nefrokids, Departamento de Nefrologia Pediátrica, Curitiba, PR, Brazil.
| | - Ubirajara Barroso
- Universidade Federal da Bahia e Escola Bahiana de Medicina e Saúde Pública, Departamento de Uronefrologia, Salvador, BA, Brazil
| | | | - Cleidimara Scremim
- Universidade Federal do Paraná, Departamento de Fisioterapia, Curitiba, PR, Brazil
| | | | - Rob A de Bie
- Maastricht University, School of Health, Medicine and Life Sciences, Department of Epidemiology, The Netherlands
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Lionarons JM, de Groot IJM, Fock JM, Klinkenberg S, Vrijens DMJ, Vreugdenhil ACE, Medici-van den Herik EG, Cuppen I, Jaeger B, Niks EH, Hoogerhuis R, Platte-van Attekum N, Feron FJM, Faber CG, Hendriksen JGM, Vles JSH. Prevalence of Bladder and Bowel Dysfunction in Duchenne Muscular Dystrophy Using the Childhood Bladder and Bowel Dysfunction Questionnaire. Life (Basel) 2021; 11:life11080772. [PMID: 34440515 PMCID: PMC8399211 DOI: 10.3390/life11080772] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/29/2021] [Accepted: 07/27/2021] [Indexed: 12/27/2022] Open
Abstract
Introduction: Lower urinary tract symptoms (LUTS) and gastrointestinal (GI) problems are common in Duchenne muscular dystrophy (DMD), but not systematically assessed in regular care. We aimed to determine the prevalence of bladder and bowel dysfunction (BBD) in DMD patients compared with healthy controls (HC). Methods: The Childhood Bladder and Bowel Dysfunction Questionnaire (CBBDQ) based on the International Rome III criteria and the International Children’s Continence Society was filled out by 57 DMD patients and 56 HC. Additionally, possible associations of BBD with, for example, medication use or quality of life were evaluated in an additional questionnaire developed by experts. Results: In 74% of patients versus 56% of HC ≥ 1 LUTS (n.s.) were reported, 68% of patients versus 39% of HC reported ≥1 bowel symptom (p = 0.002) and 53% of patients versus 30% of HC reported combined LUTS and bowel symptoms (p = 0.019). A negative impact of BBD on daily life functioning was reported by 42% of patients. Conclusions: These data underscore that standard screening for BBD is needed and that the CBBDQ could be of added value to optimize DMD care.
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Affiliation(s)
- Judith M. Lionarons
- Department of Neurology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (S.K.); (C.G.F.)
- School for Mental Health and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands;
- Correspondence: ; Tel.: +31-(0)43-3875058
| | - Imelda J. M. de Groot
- Department of Rehabilitation Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
- Duchenne Center Netherlands, 2333 ZA Leiden, The Netherlands; (E.H.N.); (J.G.M.H.)
| | - Johanna M. Fock
- Department of Neurology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands;
| | - Sylvia Klinkenberg
- Department of Neurology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (S.K.); (C.G.F.)
| | - Desiree M. J. Vrijens
- Department of Urology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
| | - Anita C. E. Vreugdenhil
- Department of Pediatrics, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
- School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
| | | | - Inge Cuppen
- Department of Neurology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands;
| | - Bregje Jaeger
- Department of Neurology, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands;
| | - Erik H. Niks
- Duchenne Center Netherlands, 2333 ZA Leiden, The Netherlands; (E.H.N.); (J.G.M.H.)
- Department of Neurology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Rinske Hoogerhuis
- Youth Healthcare Center South Limburg, 6411 TE Heerlen, The Netherlands; (R.H.); (N.P.-v.A.)
| | | | - Frans J. M. Feron
- Department of Social Medicine, Maastricht University, 6229 ER Maastricht, The Netherlands;
| | - Catharina G. Faber
- Department of Neurology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands; (S.K.); (C.G.F.)
- School for Mental Health and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands;
| | - Jos G. M. Hendriksen
- Duchenne Center Netherlands, 2333 ZA Leiden, The Netherlands; (E.H.N.); (J.G.M.H.)
- Center for Neurological Learning Disabilities, Kempenhaeghe, 5591 VE Heeze, The Netherlands
| | - Johan S. H. Vles
- School for Mental Health and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands;
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Barco-Castillo C, Mejía N, Echeverry M, Ramos A, Fernández N, Pérez J. Prevalence of Bladder and Bowel Dysfunction in the Outpatient Clinic of Pediatric Urology and Nephrology. Rev Urol 2020. [DOI: 10.1055/s-0040-1713925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Abstract
Objective Bladder and bowel dysfunction (BBD) is defined as the presence of functional alterations in both organs. The correct diagnosis and treatment prevent the exposure of patients to multiple antibiotic treatments, invasive procedures and radiological studies. The aim of the present study was to estimate the prevalence of BBD in the outpatient clinic of pediatric urology and nephrology.
Methods A prospective cohort composed of 334 patients aged between 5 and 18 years was evaluated. The Pediatric Lower Urinary Tract Symptom Score (PLUTSS) was applied. A score higher than 8 was considered as significant urinary symptomatology. Moreover, the Bristol Stool Scale and the Rome IV Criteria for functional constipation and fecal incontinence were used. Patients with organic pathologies were excluded. The risk factors were evaluated using logistic regression models.
Results The median age was 9 years old (interquartile range [IQR]: 6–13). The PLUTSS questionnaire was significant in 16.5% of the kids, constipation was found in 31.9%, and fecal incontinence, in 4%. The prevalence of BBD was of 27.8%. The female gender (odds ratio [OR]: 2.47; p = 0.002) and psychological disorders (OR: 4.637; p = 0.024) were considered risk factors. The evaluation of the PLUTSS questionnaire showed relevance regarding incontinence (OR: 3.059; p = 0.038), enuresis (OR: 8.532; p < 0.001); intermittent flow (OR: 9.211; p = 0.004), frequency (OR: 6.73; p = 0.005), and constipation (OR: 34.46; p < 0.001).
Conclusions The prevalence of BBD is of 27.8% in the outpatient clinic. It is important to prevent associated complications and the exposure to multiple antibiotic treatments, as well as invasive and imaging procedures, which also generate high costs to the health system.
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Affiliation(s)
- Catalina Barco-Castillo
- Department of Urology, Pediatric Urology and Nephrology Clinic, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia
- School of Medicine, Universidad de los Andes, Bogotá DC, Colombia
| | - Natalia Mejía
- Department of Urology, Pediatric Urology and Nephrology Clinic, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia
| | - Mariana Echeverry
- Department of Urology, Pediatric Urology and Nephrology Clinic, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia
- School of Medicine, Universidad de los Andes, Bogotá DC, Colombia
| | - Anamaría Ramos
- Department of Urology, Pediatric Urology and Nephrology Clinic, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia
| | - Nicolás Fernández
- Division of Urology, Seattle Children’s Hospital University of Washington, Seattle, Washington, United States
| | - Jaime Pérez
- Department of Urology, Pediatric Urology and Nephrology Clinic, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia
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da Silva Filho JC, Ramos Vieira Santos IC, Valença MP, Mendes Morato JE, Ferreira Dos Santos Filho SR, Lessa de Andrade A. Assessment instruments for lower urinary tract dysfunction in children: Symptoms, characteristics and psychometric properties. J Pediatr Urol 2020; 16:636-644. [PMID: 32798106 DOI: 10.1016/j.jpurol.2020.07.031] [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: 08/13/2019] [Revised: 06/04/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The use of instruments to assess symptoms of the lower urinary tract has increased mainly when it comes to pediatric urology. The search for a validated and reliable one for use in clinical practice should be a concern of the professionals involved in the care of these children. OBJECTIVE The aim of this study was to analyze the assessment instruments for lower urinary tract dysfunction in children regarding: symptoms, characteristics and psychometric properties. STUDY DESIGN PubMed and Latin American and Caribbean Literature in Health Sciences databases were searched. The PICO strategy was used to construct the research question and bibliographic search. Keywords included voiding disorders, LUTS, Child, Surveys and Questionnaires. RESULTS Nine articles were identified. The construct observed by all instruments was bladder dysfunction and seven instruments also assessed bowel dysfunction. Thirty different events were addressed. In eight instruments the respondents are the parents. The age of the target population ranged from three to eighteen years and regarding the number of items, an average of 21.8 items was observed. Six instruments showed good results of reliability and four presented good results of accuracy. CONCLUSIONS The instruments included a wide range of symptoms related to dysfunction. Only two reported all validation and reliability tests, however six instruments showed good reliability results, making them eligible for the cross-cultural adaptation and validation process for use in countries other than those of the instrument's origin.
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Aydın G, van Engelenburg - van Lonkhuyzen ML, Baktır S, Kaya Mutlu E, Mutlu C, de Bie RA. The Turkish version of the childhood bladder and bowel dysfunction questionnaire (CBBDQ): Cross-cultural adaptation, reliability and construct validity. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2020; 31:482-488. [PMID: 32721920 PMCID: PMC7433991 DOI: 10.5152/tjg.2020.19348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/10/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS Bladder and bowel dysfunction (BBD) are both prevalent health problems in pediatric population. The CBBDQ is a parent-reported tool to evaluate and quantitatively assess bladder and bowel dysfunction symptoms in pediatric patients. This study was designed for the translation the CBBDQ into Turkish and the cultural adaptation of CBBDQ for the use among 5-12-year-old children. Moreover, another aim of this study was that the determination of the reliability and construct validity of the Turkish version. The main hypothesis of our study was that the translation and cultural adaptation of the CBBDQ into Turkish language, so that Turkish parents could understand it. Additionally, we estimated that the Turkish version would have eventual internal consistency and test-retest reliability and admissible construct validity. MATERIALS AND METHODS The CBBDQ was guideline driven translated into Turkish language and administered two times to the parents of children with one week interval to assess test-retest reliability. The internal consistency was determined by using Cronbach's α value and the test-retest reliability was calculated by using the inter-rater correlation coefficient. For the estimation of construct validity, the Dysfunctional Voiding and Incontinence Scoring System (DVISS) and Pediatric Quality of Life Inventory (PedsQL) in 5-7, 8-12 years old children were used as the external criterias. RESULTS The participants were parents of 5-12-year-old children. The internal consistency was 0.83 that was the Cronbach's α value which reflects a good result. The Turkish-CBBDQ5-12y and the DVISS showed a satisfactory level correlation (r=0.64 P<0.001). There was not any correlation between the Turkish-CBBDQ5-12y and the PedsQL-General Health and PedsQL-Psychological Health (r=-0.17, P=0.1 and r:0.12 P=0.25, respectively). CONCLUSION The Turkish-CBBDQ5-12y version is a reliable and valid instrument in terms of the content and construction and can be confidently used in clinical practice.
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Affiliation(s)
- Gamze Aydın
- Division of Physiotherapy and Rehabilitation, İstanbul Okan University School of Health Sciences, Istanbul, Turkey
- Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Institute of Graduate Education, Istanbul, Turkey
| | - Marieke L. van Engelenburg - van Lonkhuyzen
- Deparment of Epidemiology, Maastricht University, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Seda Baktır
- Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Institute of Graduate Education, Istanbul, Turkey
| | - Ebru Kaya Mutlu
- Division of Physiotherapy and Rehabilitation, İstanbul University-Cerrahpasa School of Health Sciences, İstanbul, Turkey
| | - Caner Mutlu
- Department of Child and Adolescent Psychiatry, Bakirkoy Mazhar Osman Training and Research Hospital, İstanbul, Turkey
| | - Rob A. de Bie
- Deparment of Epidemiology, Maastricht University, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
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The complex relationship between urinary and defecatory disorders in young and adolescent girls. Curr Opin Obstet Gynecol 2019; 31:317-324. [PMID: 31361608 DOI: 10.1097/gco.0000000000000561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Scientific advancements have led to enhanced clarity about the interrelationship between urinary tract pathology and functional bowel disturbances. The present article will review the current literature regarding the cause, pathophysiology, diagnosis, and treatment of lower urinary tract dysfunction and abnormal bowel habits in young and adolescent girls. RECENT FINDINGS Complex neurological, physiological mechanisms and functional behaviors exist that contribute to the development of coexisting urinary symptoms and defecatory disorders in young and adolescent girls. Bladder bowel dysfunction (BBD) in childhood and adolescence is carried into adulthood creating a lifetime health burden. SUMMARY Practitioners should be aware and actively screen for conditions mimicking BBD with time-efficient and effective history-taking and physical exams that reduce anxiety and fear. The present review provides guide to comprehensive treatment strategies for managing complex pelvic floor disorders including urinary incontinence, defecatory disorders, pelvic and perineal pain, and constipation. More research is needed to elucidate pathophysiology and optimal treatment strategies of the BBD.
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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.
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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
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Functional Pelvic Floor Disorders: Concurrent Bowel and Bladder Symptoms. J Pediatr Gastroenterol Nutr 2017; 64:847-848. [PMID: 27906798 DOI: 10.1097/mpg.0000000000001486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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van Engelenburg–van Lonkhuyzen ML, Bols EM, Benninga MA, Verwijs WA, de Bie RA. Bladder and bowel dysfunctions in 1748 children referred to pelvic physiotherapy: clinical characteristics and locomotor problems in primary, secondary, and tertiary healthcare settings. Eur J Pediatr 2017; 176:207-216. [PMID: 27995361 PMCID: PMC5243895 DOI: 10.1007/s00431-016-2824-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 11/30/2016] [Accepted: 12/08/2016] [Indexed: 01/30/2023]
Abstract
UNLABELLED The aims of this study are to evaluate in a pragmatic cross-sectional study, the clinical characteristics of childhood bladder and/or bowel dysfunctions (CBBD) and locomotor problems in the primary through tertiary health care setting. It was hypothesized that problems would increase, going from primary to tertiary healthcare. Data were retrieved from patient-records of children (1-16 years) presenting with CBBD and visiting pelvic physiotherapists. Prevalence's of dysfunctions were compared between healthcare settings and gender using ANOVA and chi-square test. Agreement between physicians' diagnoses and parent-reported symptoms was evaluated (Cohen's Kappa). One thousand seventy hundred forty-eight children (mean age 7.7 years [SD 2.9], 48.9% boys) were included. Daytime urinary incontinence (P = 0.039) and enuresis (P < 0.001) were more diagnosed in primary healthcare, whereas constipation (P < 0.001) and abdominal pain (P = 0.009) increased from primary to tertiary healthcare. All parent-reported symptoms occurred more frequently than indicated by the physicians. Poor agreement between physicians' diagnoses and parent-reported symptoms was found (k = 0.16). Locomotor problems prevailed in all healthcare settings, motor skills (P = 0.041) and core stability (P = 0.015) significantly more in tertiary healthcare. CONCLUSIONS Constipation and abdominal pain (physicians' diagnoses) and the parent-reported symptoms hard stools and bloating increased from primary to tertiary healthcare. Discrepancies exist between the prevalence's of physicians' diagnoses and parent-reported symptoms. Locomotor problems predominate in all healthcare settings. What is Known: • Childhood bladder and/or bowel dysfunctions (CCBD) are common. • Particularly tertiary healthcare characteristics of CBBD are available What is New: • Characteristics of CBBD referred to pelvic physiotherapy are comparable in primary, secondary, and tertiary healthcare settings. • Concomitant CBBD appeared to be more prevalent than earlier reported. • Discrepancies exist between referring physicians' diagnoses and parent-reported symptoms.
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Affiliation(s)
- Marieke L. van Engelenburg–van Lonkhuyzen
- grid.412966.eDepartment of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), PO Box 616, 6200 MD Maastricht, the Netherlands
| | - Esther M.J. Bols
- grid.412966.eDepartment of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), PO Box 616, 6200 MD Maastricht, the Netherlands
| | - Marc A. Benninga
- Department of Paediatric Gastroenterology, Emma Children’s Hospital/Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Wim A. Verwijs
- Zuwe Hofpoort Ziekenhuis, Polanerbaan 2, 3447 GN Woerden, the Netherlands
| | - Rob A. de Bie
- grid.412966.eDepartment of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), PO Box 616, 6200 MD Maastricht, the Netherlands
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