CONSTIPATION AND LOWER URINARY DYSFUNCTION IN CHILDREN. HOW THEY ARE RELATED? A POPULATION-BASED STUDY
Ubirajara Barroso, Jr., M.D.1, Clara S. Dias, Medical Student2, Maria Luiza Veiga, Physiotherapist2, Ana Aparecida N. Braga, Psychologist2, José Murillo B. Netto, M.D.3, Ariane S. Sousa, M.D.1.
1Federal University of Bahia, Bahiana School of Medicine, Salvador, Brazil, 2Bahiana School of Medicine, Salvador, Brazil, 3Federal University of Juiz de Fora, Juiz de Fora, Brazil.
BACKGROUND: In spite of BBD being well described, to our knowledge, there are no population studies to assess in detail the association between symptoms of constipation and lower urinary tract symptoms (LUTS).
Thus, this study aims to evaluate the correlation between constipation and LUTS and nocturnal enuresis in a population analysis.
METHODS- This is a cross-sectional study in two Brazilian cities. We included patients from 5 to 17 years old and excluded those with neurological problems and anatomical abnormalities of the urinary tract. To identify the presence and severity of LUTS, we used the DVSS. It was considered as having LUT dysfunction when DVSS scored 6 in girls and 9 in boys. To evaluate the presence of constipation, ROME III was applied.
RESULTS- 829 children and adolescents with their mother were interviewed (50.2% were male). The mean age was 9.1 ± 2.9 years. The overall prevalence of LUT dysfunction was 9.1%, being predominantly in girls (15% vs. 3.1%, p<0.001). According to the Rome III, 9.4% and 12.3% of boys and girls were constipated, respectively (p = 0.169).
Of people with LUT dysfunction, 35.2% were constipated in comparison with 8.2% of those without it (p <0.001). Using the Spearman test, constipated children were 6.78 (95% CI, 3.83-12) times more likely to have LUT dysfunction than those not constipated (p <0.001).
Considering the results of the multivariate analysis, we found that infrequent voiding (p = 0.004) and holding maneuvers (p = 0.000) were independent factors associated with constipation, and other symptoms such as urgency, incontinence or frequency were not.
We also found that children and adolescents who have a more severe constipation had a worse LUTS (p <0.001). We did not found association between nocturnal enuresis and constipation (p = 0.483).
CONCLUSION- Children and adolescents with constipation were 6.78 more likely to have LUT dysfunction. The only LUTS associated with constipation were holding maneuvers and infrequent voiding. Children with more severe constipation have more prominent LUTS.
Back to 2016 Fall Congress