Effect of constipation treatment on children with lower urinary tract symptoms
DOI:
https://doi.org/10.5489/cuaj.9686Keywords:
Children, constipation, bladder dysfunctionAbstract
Introduction: We aimed to evaluate the effects of constipation treatment on lower urinary tract symptoms (LUTS) in children presenting with both conditions.
Methods: A total of 60 children with LUTS and concomitant constipation were included. Constipation was diagnosed with the Rome IV criteria, based on clinical history and validated assessment tools, including the Voiding Dysfunction Symptom Score (VDSS) and the Bristol Stool Form Scale (BSFS). All patients received oral lactulose treatment and were followed for one month. LUTS parameters were assessed subjectively and objectively through bladder diaries, uroflowmetry, postvoid residual (PVR) volumes, and symptom scores.
Results: The median age of the cohort was 90 months; 45% were male. Pre-treatment, 75% of patients demonstrated normal uroflow patterns, which increased to 93.3% post-treatment. Significant improvements were observed in maximum and minimum voided volumes from bladder diaries (p<0.001 for both), as well as in uroflowmetry parameters, including maximum flow rate (Qmax), voided volume, and PVR (p<0.001, p<0.001, p=0.001, respectively). Symptom assessment, including VDSS, BSFS, and quality of life (QoL), also showed statistically significant improvements post-treatment (p<0.001 for all). Subgroup analysis revealed significant differences in bladder diary and uroflowmetry parameters between treatment responders and non-responders. In multivariate logistic regression, only maximum voided volume from bladder diaries and voided volume on uroflowmetry were independently associated to treatment response.
Conclusions: Treatment of constipation in children with LUTS leads to significant improvements in both subjective and objective parameters. Comprehensive evaluation and management of bowel function should be considered a fundamental component in the care of paediatric patients with LUTS.
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