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Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population.
J Urol. 2005 Mar; 173(3):969-73.JU

Abstract

PURPOSE

Functional voiding problems in children are common. Although pathophysiology and presentation of this clinical entity are well described, there is not yet a generally accepted method of quantitative and standard evaluation of clinical symptoms, and there are few studies addressing the issue of symptom scoring in children. We investigated use of a symptom scoring system in children with functional voiding problems and the normal population, and validated it using a scientific tool.

MATERIALS AND METHODS

A symptom scoring system was designed empirically. The questionnaire was composed of items regarding daytime symptoms, nighttime symptoms, voiding habits, bowel habits and quality of life. There were 2 groups whose symptoms were evaluated using this scoring system. Group 1 consisted of 86 patients who were admitted to our clinic with various wetting and daytime voiding problems. Group 2 consisted of 265 controls with no urological complaints. Parents of all children were asked to fill out a questionnaire that included the symptom scoring system. Boys with lower urinary tract abnormalities, and patients with spina bifida occulta and neurogenic bladder were excluded from the study. Odds ratios of answers to each item in the questionnaire were used to define strength of the questions to differentiate patients from healthy controls. According to the value of odds ratios, questions were modified and a score for each question was given. Receiver operating characteristic plots were used to define detection cutoff or threshold score, and Youden's index was used to detect best reflecting optimal sensitivity and specificity.

RESULTS

The total score was determined to range from 0 to 35, and items were modified to 13 questions and 1 quality of life question at the end of the study. Among the 86 patients in group 1 (female-to-male ratio 1.5:1) mean score was 18.56. Among the 265 controls in group 2 (female-to-male ratio 1.5:1) mean score was 2.88. Statistical analysis revealed that within a confidence interval of 96.2% patients with a score of 8.5 or greater had voiding abnormalities, with 90% sensitivity and 90% specificity. There were no statistically significant differences between the 2 genders and 2 age groups of 4 to 7 and 8 to 10 years.

CONCLUSIONS

This statistically validated functional voiding problems symptom score may provide accurate, objective and scientific bases to grade the symptoms in comparative research, diagnosis, treatment and followup of patients with wetting and functional voiding disorders.

Authors+Show Affiliations

Department of Urology, Division of Pediatric Urology, Hacettepe University School of Medicine, Ankara, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15711352

Citation

Akbal, Cem, et al. "Dysfunctional Voiding and Incontinence Scoring System: Quantitative Evaluation of Incontinence Symptoms in Pediatric Population." The Journal of Urology, vol. 173, no. 3, 2005, pp. 969-73.
Akbal C, Genc Y, Burgu B, et al. Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. J Urol. 2005;173(3):969-73.
Akbal, C., Genc, Y., Burgu, B., Ozden, E., & Tekgul, S. (2005). Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. The Journal of Urology, 173(3), 969-73.
Akbal C, et al. Dysfunctional Voiding and Incontinence Scoring System: Quantitative Evaluation of Incontinence Symptoms in Pediatric Population. J Urol. 2005;173(3):969-73. PubMed PMID: 15711352.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. AU - Akbal,Cem, AU - Genc,Yasemin, AU - Burgu,Berk, AU - Ozden,Ender, AU - Tekgul,Serdar, PY - 2005/2/16/pubmed PY - 2005/3/30/medline PY - 2005/2/16/entrez SP - 969 EP - 73 JF - The Journal of urology JO - J Urol VL - 173 IS - 3 N2 - PURPOSE: Functional voiding problems in children are common. Although pathophysiology and presentation of this clinical entity are well described, there is not yet a generally accepted method of quantitative and standard evaluation of clinical symptoms, and there are few studies addressing the issue of symptom scoring in children. We investigated use of a symptom scoring system in children with functional voiding problems and the normal population, and validated it using a scientific tool. MATERIALS AND METHODS: A symptom scoring system was designed empirically. The questionnaire was composed of items regarding daytime symptoms, nighttime symptoms, voiding habits, bowel habits and quality of life. There were 2 groups whose symptoms were evaluated using this scoring system. Group 1 consisted of 86 patients who were admitted to our clinic with various wetting and daytime voiding problems. Group 2 consisted of 265 controls with no urological complaints. Parents of all children were asked to fill out a questionnaire that included the symptom scoring system. Boys with lower urinary tract abnormalities, and patients with spina bifida occulta and neurogenic bladder were excluded from the study. Odds ratios of answers to each item in the questionnaire were used to define strength of the questions to differentiate patients from healthy controls. According to the value of odds ratios, questions were modified and a score for each question was given. Receiver operating characteristic plots were used to define detection cutoff or threshold score, and Youden's index was used to detect best reflecting optimal sensitivity and specificity. RESULTS: The total score was determined to range from 0 to 35, and items were modified to 13 questions and 1 quality of life question at the end of the study. Among the 86 patients in group 1 (female-to-male ratio 1.5:1) mean score was 18.56. Among the 265 controls in group 2 (female-to-male ratio 1.5:1) mean score was 2.88. Statistical analysis revealed that within a confidence interval of 96.2% patients with a score of 8.5 or greater had voiding abnormalities, with 90% sensitivity and 90% specificity. There were no statistically significant differences between the 2 genders and 2 age groups of 4 to 7 and 8 to 10 years. CONCLUSIONS: This statistically validated functional voiding problems symptom score may provide accurate, objective and scientific bases to grade the symptoms in comparative research, diagnosis, treatment and followup of patients with wetting and functional voiding disorders. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/15711352/Dysfunctional_voiding_and_incontinence_scoring_system:_quantitative_evaluation_of_incontinence_symptoms_in_pediatric_population_ L2 - https://www.jurology.com/doi/10.1097/01.ju.0000152183.91888.f6?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -