Abstract

Objective: Urinary tract infection (UTI) is one of the most common bacterial infections of children. The aims of this study were to evaluate voiding disfunction, and the effect of standart uroteraphy on the symptoms of disfunctional voiding in children with recurrent urinary tract infection.

 Material and Methods: Between March 2006 and June 2008, 99 patients aged ≥4 years who had UTI at least twice in a year were evaluated. The cases were assessed by uroflowmetry and dysfunctional voiding symptom score (DVSS). 68 patients with voiding dysfunction administered standard urotherapy. These patients were reevaluated for symptoms of voiding dysfunction at the end of six month - standart urotherapy.

 Results: Ninety-six (98%) of the 98 patients were female, mean age was 9.9±3.95 years. DVSS was ≥8.5 in 68 (72%) patients. Constipation was found in 48 patients (49%). 86 of 46 patients (54%) had high residual urine volume (>20 ml). Uroflowmetric examinations were performed in 86 patients. 40 patients (47%) had bell, 21 patients (22%) had staccato, 20 patients (21%) had fractioned, 1 patient (1%) tower, 4 patients (4%) had plateau shaped voiding curve. 68 patients with high DVSS underwent standard urotherapy. At the end of six month- standart urotherapy, the DVS score was ≤ 8.5 in 35 patients. Complete recovery was found in 68% of diurnal enuresis, 58% in nocturnal enuresis, 84% in intermittent incontinence, 91% in feeling of incomplete urination and re-voiding.

 Conclusion: DVSS and uroflowmetry are practical methods for defining voiding dysfunction. Standard urotherapy is an effective treatment technique for the recovery of symptoms of voiding dysfunction.

Keywords: Children, Prognosis, Standard urotherapy, Urinary tract infection

References

  1. 1. Santos JD, Lopes RI, Koyle MA. Bladder and bowel dysfunction in
  2. children: Anupdate on the diagnosis and treatment of a common,
  3. but under diagnosed pediatric problem. Can Urol Assoc J
  4. 2017;11:64-72.
  5. 2. Chrzan R, Klijn AJ, Vijverberg MA, Sikkel F, de Jong TP. Colonic
  6. washout enemas for persistent constipation in children with
  7. recurrent urinary tract infections based on dysfunctional voiding.
  8. Urology 2008;71: 607-10.
  9. 3. Hellström A, Hanson E, Hansson S, Hjälmås K, Jodal U. Association
  10. between urinary symptoms at 7 years old and previous urinary
  11. tract infection. Arch Dis Child 1991;66:232-4.
  12. 4. Kim JH, Lee JH, Jung AY, Lee JW. The prevalence and therapeutic
  13. effect of constipation in pediatric overactive bladder. Int Neurourol
  14. J 2011;15:206-10.
  15. 5. Lucanto C, Bauer SB, Hyman PE, Flores AF, Di Lorenzo C.
  16. Function of hollow viscera in children with constipation and voiding
  17. difficulties. Dig Dis Sci 2000;45:1274-80.
  18. 6. Kasirga E, Akil I, Yilmaz O, Polat M, Gözmen S, Egemen A.
  19. Evaluation of voiding dysfunctions in children with chronic functional
  20. constipation. Turk J Pediatr 2006;48: 340-3.
  21. 7. Averbeck MA, Madersbacher H. Constipation and LUTS – how do
  22. they affect each other? Int Braz J Urol 2011;37:16-28.
  23. 8. Akbal C, Genç, Y, Burgu, B, Ozden E, Tekgul S, Dysfunctıonal
  24. voiding and incontinence symptoms in pediatric population. J Urol
  25. 2005;173:969-73.
  26. 9. Kanematsu A, Johnin K, Yoshimura K, Okubo K, Aoki K, Watanabe
  27. M, et al. Objective patterning of uroflowmetry curves in children
  28. with daytime and nighttime wetting. J Urol 2010;184:1674-9.
  29. 10. Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, et al.
  30. The standardization of terminology of lower urinary tract function in
  31. children and adolescents: Update report from the Standardization
  32. Committee of the International Children’s Continence Society. J
  33. Urol 2014;191:1863-5.
  34. 11. SJ Chang, LP Tsai, CK Hsu, SS Yang. Elevated postvoid residual
  35. urine volume predicting recurrence of urinary tract infections in
  36. toilet-trained children. Pediatr Nephrol 2015;30:1131-7.
  37. 12. Kibar Y, Piskin M, Irkilata HC, Aydur E, Gok F, Dayanc M.
  38. Management of abnormal postvoid residual urine in children with
  39. dysfunctional voiding.Urology 2010;75:1472-5.
  40. 13. O’Regan S, Yazbeck S. Constipation: A cause of enuresis,
  41. urinary tract infection and vesico-ureteral reflux in children. Med
  42. Hypotheses 1985;17:409-13.
  43. 14. Robson WL, Leung AK, Bloom DA. Daytime wetting in childhood.
  44. Clin Pediatr 1996;35:91-8.
  45. 15. Nevéus T, Sillén U. Sillen. Lower urinary tract function in childhood;
  46. normal development and common functional disturbances. Acta
  47. Physiol (Oxf) 2013;207:85-92.
  48. 16. Gondim R, Azevedo R, Braga AANM, Veiga ML, Barroso U Jr. Risk
  49. factors for urinary tract infection in children with urinary urgency. Int
  50. Braz J Urol 2018;44:378-83.
  51. 17. Allen TD, Bright TC 3rd. Bright. Urodynamic patterns in children
  52. with dysfunctional voiding problems. J Urol 1978;119:247-49.
  53. 18. Bartkowski DP, Doubrava RG. Ability of a normal dysfunctional
  54. voiding symptom score to predict uroflowmetry and external
  55. urinary sphincter electromyography patterns in children. J Urol
  56. 2004;172:1980-5.
  57. 19. Sinha S. Dysfunctional voiding: A review of the terminology,
  58. presentation, evaluation and management in children and adults.
  59. Indian J Urol 2011;27:437-47.
  60. 20. Chang SJ, Chiang IN, Hsieh CH, Lin CD, Yang SS. Age‐and
  61. gender‐specific nomograms for single and dual post‐void residual
  62. urine in healthy children. Neurourol Urodyn 2013;32:1014-8.
  63. 21. Neveus T, Gontard A, Hoebeke P. The standartization of terminology
  64. of lower urinary tract function in children and adolescents: Report
  65. from the standartization committee of the International Children’s
  66. Continence Society. J Urol 2006;176:314–24.
  67. 22. Koff SA, Wagner TT, Jayanthi VR. The relationship among
  68. dysfunctional Elimination syndromes, primary vesicoureteral reflux
  69. and urinary tract infections in children. J Urol 1998;160:1019-22.
  70. 23. Hodges SJ, Anthony EY. Occult mega rectum-A commonly
  71. unrecognized cause of enuresis. Urology 2012;79:421-4.
  72. 24. Hagstroem S, Rittig S, Kamperis K, Djurhuus JC. Timer watch
  73. assisted urotherapy in children: A randomized controlled trial. J
  74. Urol 2010;184:1482-8.
  75. 25. Bulum B, Özçakar ZB, Kavaz A, Hüseynova M, Ekim M, Yalçinkaya
  76. F. Lower urinary tract dysfunction is frequently seen in urinary tract
  77. infections in childrenand is often associated with reduced quality of
  78. life. Acta Paediatr 2014;103:454-8.

Copyright and license

How to cite

1.
Say B. Evaluation of Voiding Dysfunction and Response to Standard Uroterapy in Children with Recurrent Urinary Tract Infections. Turk J Pediatr Dis [Internet]. 2019 Dec. 23 [cited 2025 May 25];13(6):456-62. Available from: https://turkjpediatrdis.org/article/view/557