MP56-09 PICTORIAL URGENCY SCALE – A NEW TOOL FOR EVALUATING BLADDER PERCEPTION IN CHILDREN

Abstract

You have accessJournal of UrologyPediatrics: Dysfunctional Voiding & Enuresis1 Apr 2018MP56-09 PICTORIAL URGENCY SCALE – A NEW TOOL FOR EVALUATING BLADDER PERCEPTION IN CHILDREN Eric Kurzrock MD, Yvonne Chan MD, Blythe Durbin-Johnson PhD, and Lora DeCristoforo PhD, PsyD Eric Kurzrock MDEric Kurzrock MD More articles by this author , Yvonne Chan MDYvonne Chan MD More articles by this author , Blythe Durbin-Johnson PhDBlythe Durbin-Johnson PhD More articles by this author , and Lora DeCristoforo PhD, PsyDLora DeCristoforo PhD, PsyD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1800AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Since verbal descriptors are not understood by all children due to language and developmental factors, pictorial scales are used to measure pain. Similarly, feelings of bladder fullness and urgency are difficult to express and thus evaluate. Our goal was to develop a pictorial urgency scale to help children indicate what they are feeling during urodynamics (Fig.). We hypothesized that these images would correlate with ICS standard verbal descriptors and that the scale would correlate with bladder volume. METHODS Arm 1: Toilet trained children and their parents were tested, excluding those with a history of UTI, voiding dysfunction, bladder or genital anomaly or surgery, and reflux. Subjects were asked to point to one of the four images after being read each of the four standard verbal descriptors: "feeling normal without need to void, you feel your bladder filling but do not need to void, your first desire to void, and strong need or desire to void." They could point to a figure more than once. Three versions of the survey with different descriptor orders were given. The correlation between verbal descriptors and figures was analyzed using a mixed effects proportional odds logistic regression model. Arm 2: Toilet trained children undergoing VCUG were shown the pictorial scale. They were asked to point to images on the scale during bladder filling. Correlation of percent of expected capacity (PEC) and image was analyzed using a linear mixed effects model. RESULTS Arm 1: 91 adults and 267 children (mean age 7 years) were surveyed. Correlation of the verbal descriptors with the pictures was 0.87 (95% CI 0.84-0.89) for all subjects, 0.84 (95% CI 0.81-0.88) for patients aged 6 years or younger, and 0.88 (95% CI 0.85-0.90) for patients aged 6 to 17 years. Correlations for male and female patients were equivalent. The sequence of the images was appropriate for increasing degree of urgency. Arm 2: (73 patients), correlation between image and PEC was 0.75 (95% CI 0.67-0.81, p<0.001). There was no significant difference between mean PEC for a given figure between genders. CONCLUSIONS Young children find it difficult to verbally express feelings of urgency and bladder fullness. Figures in the studied pictorial urgency scale correlate with both standard verbal descriptors and bladder volume. This can be a useful tool in the clinical and research setting. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e759 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Eric Kurzrock MD More articles by this author Yvonne Chan MD More articles by this author Blythe Durbin-Johnson PhD More articles by this author Lora DeCristoforo PhD, PsyD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...