BACKGROUND:Overactive bladder (OAB) is defined as urinary urgency with or without urgent urinary incontinence, usually accompanied by frequent urination and increased nocturia, without urinary tract infections or other definite lesions by International Children Continence’s Society(ICCS). Most of studies are limited to compare the differences in emotional and behavioral abnormalities between OAB children and non-OAB children, and report on the possible causes or related factors of the abnormalities is rare. Therefore, we investigated the risk factors related to emotional and behavioral abnormalities of children with OAB through a survey.
METHODS:A OAB Symptom Rating Scale (OABSS) and the Strengths and Difficulties Questionnaire (SDQ) were used to evaluate the children with OAB, who was found in our anonymous survey in 5032 children (6-16 years old) in four counties of Henan Province of Mainland China from March 2023 to December 2023. According to the SDQ score, it is divided into an abnormal score group (ASG) (≥ 20 points) and a normal score group (NSG) (˂ 20 points). The questionnaire content includes: ①General information: age, gender, place of residence, height, body mass, caregiver education level, etc. ②Past medical history: Enuresis, constipation, and treatment received; ③The Chinese version of the OAB score sheet (aggressive blader symbolscore), the diagnostic criteria used in OABSS are urgency score ≥ 2 points and total score ≥ 3 points. Using OABSS as the standard for diagnosing and evaluating the severity of OAB, a total score of ≥ 12 is classified as severe, 6-11 is classified as moderate, and ≤ 5 is classified as mild. ④Strengths and Difficulties Questionnaire(SDQ) (Parental Version) is a concise emotional and behavioral screening questionnaire.
RESULTS:The prevalence of OAB was 9.0% (385/4278) in a survey of 5032 children. Among 385 children with OAB, 137 cases (35.7%) of ASG, 248 cases (64.3%) of NSG. The chi square test shows that ASG is related to gender, caregiver education level BMI, age,constipation, enuresis. There was a significant statistical difference between the severity of OAB and NSG (P<0.05), and there was no statistically significant relationship with the place of residence (P ˃ 0.05). Multivariate regression analysis was conducted on the statistically significant factors in the above general data, and it was found that ASG had significant statistical differences compared to NSG in terms of female gender, caregiver education level above university level, high BMI, puberty, constipation, enuresis, and severe OAB (P<0.05). The Mann Whitney U test results showed that children with ASG scored higher than those with NSG in terms of emotional symptoms, conduct problems, hyperactivity symptoms, and peer interaction, with statistical significance (P<0.001).
CONCLUSIONS:The OAB ASG is common in children with OAB in Mainland China. Female, caregivers with education below university level, high BMI, adolescence, concomitant constipation, enuresis, and severe OAB are related influencing factors of OAB ASG. Emotional symptoms, conduct problems, hyperactivity symptoms, and peer interaction may be more likely to occur in children with OAB ASG.
