Introduction: Children with ADHD are 4.5x more likely to have incontinence than their peers. There are many treatment options for children with ADHD yet, previous work on comorbid ADHD and BBD has excluded children with ADHD not taking stimulant medications. Our objective is to compare children with BBD and ADHD who are or are not taking ADHD medications. Methods: We performed a review of urology patients 5-18 years old evaluated for BBD with ADHD from 1/1/2015-12/30/2022. Inclusion criteria included a diagnosis of ADHD and completion of the Iowa Urology Clinic Pediatric Bladder and Bowel Dysfunction questionnaire. A linear mixed model was used to compare BBD score trend between children taking and not taking ADHD medications.
Results: Groups included urotherapy (n=31); urotherapy & bowel medication (n=52); urotherapy, bowel & anticholinergic medications (n=26). Urotherapy-only patients off ADHD medications had a significantly larger monthly decrease in BBD score (-0.68 vs. -0.09) than those on ADHD medications, however the latter had significantly lower baseline (p = 0.005) and final BBD scores (p=0.03). In the urotherapy & bowel group, and the urotherapy, bowel & anticholinergic group, there was no significant difference in baseline BBD scores between those on or off ADHD medications (p= 0.85, p=0.62, respectively). Conclusion: ADHD medical therapy status affects BBD management in children only performing behavioral modifications such as urotherapy or potty watch. ADHD medical therapy status does not seem to affect BBD management in children prescribed additional BBD medications in addition to behavioral modification.
Results of linear mixed models comparing BBD score trend between patients taking or not taking ADHD medications in each BBD treatment group.
| BBD Treatment Subgroup | Predictors | Coefficients | 95% CI | p |
| Urotherapy | Groups (ref = No ADHD medication)ADHD medication | -13.40 | (-22.67, -4.12) | 0.005 |
| Months post baseline | -0.68 | (-1.11, -0.25) | 0.003 | |
| Groups*Months (ref = No ADHD medication)ADHD medication | 0.59 | (0.04, 1.13) | 0.04 | |
| Anticholinergic & Bowel | Groups (ref = No ADHD medication)ADHD medication | -0.84 | (-9.67, 7.99) | 0.85 |
| Months post baseline | -0.20 | (-0.76, 0.36) | 0.47 | |
| Groups*Months (ref = No ADHD medication)ADHD medication | 0.18 | (-0.44, 0.80) | 0.55 | |
| Bowel | Groups (ref = No ADHD medication)ADHD medication | 2.09 | (-6.42, 10.59) | 0.62 |
| Months post baseline | -0.41 | (-0.77, -0.04) | 0.03 | |
| Groups*Months (ref = No ADHD medication)ADHD medication | 0.08 | (-0.40, 0.56) | 0.74 |
