Changes in rat bladder function following exposure to pain and water stimuli

Urogenital tract disorders in children suspected of being sexually abused

INTRODUCTION

Child sexual abuse (CSA) is generally defined as child exploitation that leads to achievement of sexual satisfaction. According to data from European countries, sexual abuse of children affects 10-40% of girls and 5-20% of boys.

MATERIAL AND METHODS

The Medline, and Web of Science databases were searched with no date limitation on May 2015 using the terms 'child abuse' in conjunction with 'urinary tract', 'urologist', 'urological dysfunction', 'urologic symptoms', 'LUTS' or 'urinary infection'.

RESULTS

Awareness of the CSA problem among paediatricians and urologists is very important, because they are often the only physicians who are able to recognize the problem. CSA diagnosis is possible only through the proper collection of a medical history and a thorough physical examination. Urologists have to remember that children exposed to sexual abuse rarely exhibit abnormal genital findings. In fact, absence of genital findings is the rule rather than the exception. In most cases, the final diagnosis of sexual abuse is based on the child's history and behavior, along with the onset and exacerbation of urologic symptoms.

CONCLUSIONS

In this article, we present a review of studies and literature concerning urinary symptoms in sexually abused children to clarify the problem for a broad group of urologists. We present common symptoms and premises that can point to the right diagnosis and basic guidelines of proceeding after suspicion of abuse.

Is abuse causally related to urologic symptoms? Results from the Boston Area Community Health (BACH) Survey

OBJECTIVES

We investigated (1) whether sexual, physical, or emotional abuse experienced either as a child or as an adolescent/adult is associated with symptoms of urinary frequency, urgency, and nocturia, and (2) the extent to which the observed association between abuse and urologic symptoms may be causal.

METHODS

Analyses are based on data from the Boston Area Community Health (BACH) survey, a community-based epidemiologic study of many different urologic symptoms and risk factors. BACH used a multistage stratified cluster sample to recruit 5506 adults, aged 30-79 yr (2301 men, 3205 women; 1770 black [African American], 1877 Hispanic, and 1859 white respondents).

RESULTS

The symptoms considered are common, with 33% of BACH respondents reporting urinary frequency, 12% reporting urgency, and 28% reporting nocturia. All three symptoms are positively associated with childhood and adolescent/adult sexual, physical, and emotional abuse (p<0.05), with abuse significantly increasing the odds of urinary frequency by a factor ranging from 1.6 to 1.9, the odds of urgency by a factor from 2.0 to 2.3, and the odds of nocturia by a factor from 1.3 to 1.5.

CONCLUSIONS

Our analyses extend previous work. First, we show a strong association between abuse and urinary frequency, urgency, and nocturia in a community-based random sample. Second, we move beyond discussion of statistical association and find considerable evidence to suggest that the relationship between abuse and these symptoms may be causal.