Abstract
Lower urinary tract dysfunction (LUTD) in childhood might affect lower urinary tract function and psychological wellbeing later in life. This study presents long-term functional outcome, psychological outcome and quality of life (QOL) of adolescents and young adults treated for childhood LUTD compared to healthy age-matched controls. In addition, association with past treatment outcomes is evaluated. A single-centre cross-sectional study of former patients treated in childhood (currently 16-26 years old) was conducted. Participants completed a survey composed from validated questionnaires: the Overactive Bladder Questionnaire, the Hospital Anxiety and Depression Scale, the Pediatric Quality of Life Inventory and the Short Form 36 Health Survey. Fifty-two former patients (out of 133) agreed to participate and returned the survey (mean age 21 ± 4.1 years). Sixty-nine control subjects were included (mean age 21 ± 2.9 years). Urinary tract symptoms were more common in former patients than controls. Storage symptoms more frequently reported were (urge) urinary incontinence, stress urinary incontinence (SUI) and nocturia. Voiding symptoms more frequently reported were intermittency and feeling of incomplete emptying, Fig. 1. There were no differences in urinary tract symptoms or urinary incontinence subdivided by childhood treatment outcome (complete response, partial response or no response), respectively p = 0.17 and p = 0.58. Results of the overactive bladder questionnaire revealed higher urinary symptom bother scores (score 14 versus 5 p < 0.01) and lower disease-specific QOL (score 95 versus 98 p = 0.02) in former patients compared to controls. General QOL and psychosocial wellbeing were not significantly different between the two groups. A childhood treatment duration extending 2,5 years was an independent prognostic factor for subsequent urinary tract symptoms later in life (OR = 1.5, 95% CI 1.1-2.0). Psychological comorbidity was more often present in former patients (35%) versus controls (10%), p < 0.01. Adolescents and young adults treated for childhood LUTD are more prone to report urinary tract symptoms later in life, especially if treatment duration was extensive. However general QOL and psychosocial wellbeing later in life are not or only mildly affected.
Highlights
Lower urinary tract dysfunction (LUTD) is prevalent in up to 31% of 6e8 year-old children and approximately 5% of adolescents [1,2]
Childhood LUTD is associated with lowered self-image, lower quality of life (QOL) and a negative impact on psychosocial wellbeing at the time of occurrence [10,11]
The aim of this study is to determine the number, type, severity and impact of urinary tract symptoms in adolescents and young adults treated for childhood LUTD and to compare outcomes to those of healthy age-matched controls
Summary
Lower urinary tract dysfunction (LUTD) is prevalent in up to 31% of 6e8 year-old children and approximately 5% of adolescents [1,2]. The prevalence varies greatly between 2 and 53% depending on the selected population, type of urinary tract symptoms, severity and measurements used [3,4]. Several studies suggest a link between adult LUTD and childhood urinary incontinence (UI) [5e7]. A higher number of urinary tract symptoms are reported in young women after treatment for childhood LUTD compared to healthy age-related controls [8,9]. Other authors found childhood LUTD to be an independent risk factor for urinary tract symptoms in adulthood [6]. Less is known about the effect on psychosocial wellbeing later in life even if actual treatment has ended years ago
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