181 BLADDER AND BOWEL DYSFUNCTION: EVIDENCE FOR MULTIDISCIPLINARY CARE

Abstract

You have accessJournal of UrologyPediatrics: Dysfunctional Voiding/Enuresis1 Apr 2013181 BLADDER AND BOWEL DYSFUNCTION: EVIDENCE FOR MULTIDISCIPLINARY CARE Cortney Wolfe-Christensen, Alexandra Manolis, William Guy, Natalija Kovacevic, Najeeb Zoubi, Mohammad El-Baba, Larisa Kovacevic, and Yegappan Lakshmanan Cortney Wolfe-ChristensenCortney Wolfe-Christensen Detroit, MI More articles by this author , Alexandra ManolisAlexandra Manolis Detroit, MI More articles by this author , William GuyWilliam Guy Detroit, MI More articles by this author , Natalija KovacevicNatalija Kovacevic Detroit, MI More articles by this author , Najeeb ZoubiNajeeb Zoubi Detroit, MI More articles by this author , Mohammad El-BabaMohammad El-Baba Detroit, MI More articles by this author , Larisa KovacevicLarisa Kovacevic Detroit, MI More articles by this author , and Yegappan LakshmananYegappan Lakshmanan Detroit, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1561AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Voiding dysfunction comprises almost 40% of referrals to Pediatric Urologists, while bowel dysfunction leading to constipation accounts for 30% of referrals to Pediatric Gastroenterologists. The current study sought to examine similarities and differences between these dysfunctional elimination groups in terms of voiding symptoms and psychosocial difficulties to determine whether they might benefit from multidisciplinary care. METHODS Parents of children seen for constipation in the GI clinic were recruited during regular outpatient clinic appointments. Parents completed the Pediatric Symptom Checklist (PSC), a brief, 35-item screen for psychosocial difficulties in children, and the Dysfunctional Voiding Scoring System, a 10-item, validated scale of voiding dysfunction. Additionally, a child age and gender matched voiding dysfunction group was randomly selected from our Urology research database. Finally, historical control data were obtained from the initial validation of the DVSS. RESULTS Participants included 62 parents of children seen for constipation in the GI clinic. The Urology group was successfully matched by age and gender in 100% of the cases. Results of a one-way ANOVA (GI vs. Urology vs. Controls) revealed a significant overall model (F(2, 166) = 27.31, p<.001). Post-hoc comparisons, with Tukey's Test applied, revealed that the Urology and GI groups had significantly higher DVSS scores than the control groups (p<.001, p<.001, respectively). The difference between the Urology and GI groups was not significant. A MANOVA which compared the Urology and GI groups in terms of PSC scores was not significant. CONCLUSIONS Children referred to GI clinics for constipation have significantly elevated DVSS scores, which are comparable to scores in children seen in Urology with voiding dysfunction. Additionally, there were no differences between the groups in terms of the percentages of children who met the cut-off for clinically significant psychosocial difficulties. Therefore, these children represent a homogenous group who could potentially benefit from treatment in a multi-disciplinary clinic that includes a urologist, gastroenterologist, and psychologist. Urology Clinic (Voiding Dysfunction) GI Clinic (Constipation) Controls p-value Sex 35 M, 27 F 35 M, 27 F 23 M, 31 F Age (M +SD) 10.19 + 3.78 10.00 + 3.90 N/A DVSS Total Score 10.27 + 3.71 8.53 + 5.19 4.37 + 3.74 < .001 PSC Total Problems 19.04 + 11.85 16.83 + 10.84 — .498 PSC Attention Problems 4.02 + 2.96 3.20 + 2.52 — PSC Internalizing Problems 2.05 + 2.17 2.19 + 2.03 — PSC Externalizing Problems 3.42 + 2.94 2.90 + 3.08 — Met PSC Cut-Off 25.93 (14/54) 22.03% (15/59) — .628 © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e74 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cortney Wolfe-Christensen Detroit, MI More articles by this author Alexandra Manolis Detroit, MI More articles by this author William Guy Detroit, MI More articles by this author Natalija Kovacevic Detroit, MI More articles by this author Najeeb Zoubi Detroit, MI More articles by this author Mohammad El-Baba Detroit, MI More articles by this author Larisa Kovacevic Detroit, MI More articles by this author Yegappan Lakshmanan Detroit, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...