Lower Urinary Tract Dysfunction Symptoms and Quality of Life in Pediatric Patients
Mary E. Mahaffey, B.S.B.E., Jeunice Owens-Walton, B.S., Katherine Fratino, M.D., Bradley Morganstern, M.D..
Medical College of Georgia at Augusta University, Augusta, GA, USA.
BACKGROUND: Lower urinary tract dysfunction (LUTD) is a highly prevalent condition in children that includes urinary incontinence and other urine storage and voiding symptoms which have been shown to affect quality of life in both patients and caregivers. The first-line treatment is standard urotherapy which often includes behavioral modifications, education, noninvasive urodynamics or pharmacological therapies. These treatments have proven more effective than spontaneous remission. In previously published data, correlation between symptomology and quality of life has been established but often focused on one subtype of LUTD or smaller populations. This study will explore the correlation of enuresis type to quality of life measures using the Vancouver Non-neurogenic Lower Urinary Tract Dysfunction (VNLUTD) questionnaire and the Pediatric Incontinence Questionnaire (PinQ).
METHODS: A retrospective chart review was conducted for patients who presented to the pediatric urology clinic for LUTD from 2018-2020, and completed both the PinQ and VNLUTD. Data were extracted for subjective symptoms of LUTD and bowel dysfunction. Patients under age 5 or with neurogenic or anatomical causes of their LUTD were excluded. Correlations between PinQ and VNLUTD were established as well as by comorbid behavioral diagnosis and enuresis type.
RESULTS: Two-hundred and forty-three patients met inclusion criteria. PinQ and VNLUTD scores were positively correlated with a Pearson coefficient of 0.427 (p=0.01). Differences were observed across types of LUTD, with patients with both nocturnal and diurnal enuresis exhibiting higher symptom scores and quality of life impact than either nocturnal enuresis or diurnal enuresis alone.
CONCLUSIONS: There is a significant correlation between enuresis type, symptom severity and quality of life in pediatric patients with lower urinary tract dysfunction, as measured by VNLUTD and PinQ questionnaires. This prompts clinicians to consider the role of holistic patient care in addition to symptomatic treatment. 
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