CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2020; 29(04): 217-224
DOI: 10.1055/s-0040-1713925
Original Article | Artículo Original
Pediatric Urology/Urología Pediátrica

Prevalence of Bladder and Bowel Dysfunction in the Outpatient Clinic of Pediatric Urology and Nephrology

Prevalencia de la disfunción de la vejiga y del intestino en la consulta ambulatoria de urología y nefrología pediátrica
1  Department of Urology, Pediatric Urology and Nephrology Clinic, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia
2  School of Medicine, Universidad de los Andes, Bogotá DC, Colombia
,
1  Department of Urology, Pediatric Urology and Nephrology Clinic, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia
,
1  Department of Urology, Pediatric Urology and Nephrology Clinic, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia
2  School of Medicine, Universidad de los Andes, Bogotá DC, Colombia
,
Anamaría Ramos
1  Department of Urology, Pediatric Urology and Nephrology Clinic, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia
,
3  Division of Urology, Seattle Children’s Hospital University of Washington, Seattle, Washington, United States
,
Jaime Pérez
1  Department of Urology, Pediatric Urology and Nephrology Clinic, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia
› Author Affiliations
Funding sources The present study was supported by a research grant from the Joint Call for Research of Hospital Universitario Fundación Santa Fe de Bogotá and the School of Medicine at Universidad de los Andes (August 17th, 2018).

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.

Resumen

Objetivo El síndrome de disfunción de la vejiga y del intestino (DVI) se define como la presencia de alteraciones funcionales en ambos órganos. El correcto diagnóstico y tratamiento previene la exposición de los pacientes a múltiples manejos antibióticos, procedimientos invasivos y estudios radiológicos. El objetivo de este estudio es estimar la prevalencia de DVI en la consulta ambulatoria de urología y nefrología pediátrica.

Métodos Se evaluó una cohorte prospectiva de 334 pacientes de 5 a 18 años. Se aplicó el cuestionario de Puntuación de Síntomas del Tracto Urinario Inferior (Pediatric Lower Urinary Tract Symptom Score, PLUTSS), cuyo resultado mayor a 8 fue considerado significativo. Adicionalmente, se usó la Escala de Heces de Bristol (Bristol Stool Scale) y los Criterios Roma IV (Rome IV Criteria) para estreñimiento e incontinencia fecal. Los factores de riesgo se evaluaron bajo modelos de regresión logística.

Resultados La edad mediana fue de 9 años (rango intercuartil [RIC]: 6–13). El cuestionario PLUTSS fue significativo en 16,5% de los niños, y se observó estreñimiento en 31,9%, e incontinencia fecal en 4%. La prevalencia de DVI fue de 27,8%. El sexo femenino (razón de probabilidades [RP]: 2.47; p = 0.002) y desordenes psicológicos (RP: 4.637; p = 0.024) fueron considerados factores de riesgo. La evaluación del cuestionario PLUTSS mostró relevancia en incontinencia (RP: 3.059; p = 0.038), enuresis (RP: 8.532; p < 0.001), flujo intermitente (RP: 9.211; p = 0.004), frecuencia (RP: 6.73; p = 0.005), y estreñimiento (RP: 34.46; p < 0.001).

Conclusiones La prevalencia de DVI fue de 27.8% en la consulta ambulatoria. Es importante prevenir complicaciones asociadas y la exposición a múltiples tratamientos antibióticos, procedimientos invasivos e imagenológicos, que adicionalmente generan altos costos al sistema de salud.



Publication History

Received: 10 April 2020

Accepted: 26 May 2020

Publication Date:
06 October 2020 (online)

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