Abstract
Lower urinary tract dysfunction (LUTD) are voiding dysfunctions without anatomical or neurological defects. The diagnosis is primarily clinical, with symptoms standardized by the International Children's Continence Society. Few studies relate quality of life of patients with cognitive and school performance. To evaluate milestones of bladder control, daily problems, quality of life (QoL), cognitive function and school performance of children with LUTD. Case series of patients followed in the Pediatric Nephrology tertiary hospital with assessment of QoL (Pediatric Quality of Life Inventory - PedsQoL version 4), School Performance Test (TDE) and Raven Progressive Matrices test. Girls of lower social class were (90.9%) of eligible children. The mean age was 9.1 ± 4.8 years old. The most common symptoms were urge incontinence (81%), holding maneuvers (77.3%) and enuresis (59.1%) associated with the elimination disorder syndrome (63.6%). Caregivers considered volunteers urinary losses and/ or symptoms, and fought and/or beat the child. Children had been subjected to embarrassing situations such as warnings of teachers, they hid symptoms and/or the dirty clothes. Mean score of QoL was 71.0 ± 12.6 with the lowest mean score on the school dimension. In TDE 55% had lower performance and in Raven Matrices 60% were intellectually in the medium level. It was observed lower QoL scores in the medium and lower level of TDE and average intellectual capacity/below average in Raven matrices. LUTD may negatively affect family and social relationships, school performance and QoL of children with the dysfunction.
Highlights
Lower urinary tract dysfunction (LUTD) are voiding dysfunctions without anatomical or neurological defects
Case series of patients followed in the Pediatric Nephrology tertiary hospital with assessment of quality of life (QoL) (Pediatric Quality of Life Inventory - PedsQoL version 4), School Performance Test (TDE) and Raven Progressive Matrices test
The most common symptoms were urge incontinence (81%), holding maneuvers (77.3%) and enuresis (59.1%) associated with the elimination disorder syndrome (63.6%)
Summary
Quando as crianças com enurese ou com urgência/ urgeincontinência (20) foram questionadas sobre as situações mais comuns do seu dia-a-dia em relação às outras crianças do seu convívio, 50% (10/20) responderam que outras crianças sabem que o paciente sujava as roupas de urina, 46,1% (6/13) informaram que outras crianças sabem que eles têm enurese, 45% (9/20) já tiveram que esconder as roupas dos outros colegas no colégio, 25% (5/20) falaram que outras crianças costumam zombar do seu problema e 50% (10/20) já receberam algum apelido relacionado ao DTUI. Entre os 13 pacientes que tinham permissão dos cuidadores para frequentar a casa de amigos, 61,5% (8/13) relataram que não gostavam de ir e 53,84% (7/13) diziam ser os sintomas do DTUI o motivo de não gostar de ir. Entre os nove que tinham permissão para dormir na casa de amigos, 88,8%. (8/9) das crianças responderam que não gostavam e 77,7% (7/9) referiram que o motivo era a perda de urina durante a noite (Tabela 2). Quando interrogados sobre a escola e sobre o relacionamento com os professores (Tabela 3), 77,3% (17/22) das crianças responderam que gostavam de ir à escola, mas que o professor permitia algumas vezes, raramente ou nunca que eles fossem ao banheiro quando solicitavam. Tabela 2 Aspectos da relação com os pais, com outras crianças e com a escola das crianças e adolescentes (5 a 14 anos) portadoras de DTUI de causa funcional acompanhadas no Serviço de Nefrologia
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