The Iciq-Cluts: The First Screener Questionnaire for Lower Urinary Tract Symptoms in Children

Abstract

Purpose To date no validated instruments are available to screen lower urinary tract symptoms (LUTS) in children, even if several questionnaires deal with clinical outcome. We developed and tested for validity a screener tool (ICIQ-CLUTS), to detect LUTS in children Material and Methods A 12-items questionnaire had been designed by experts, in a children's (ICIQ-CLUTSchildren) and parents' (ICIQ-CLUTSparents) version, and submitted to a standard cross-cultural adaptation process, simultaneously in English, Italian and German languages. Items investigated: age, gender, urinary tract infection, enuresis, daytime incontinence, daytime frequency, urgency, voiding postponement, straining to void, urge incontinence, feeling of incomplete emptying, bowel movements. Questionnaires have been administered, anonymously and blended, to children (age 10-18 years) and to parents of children aged 5-18 years presenting for LUTS (cases) or attending paediatric/urological clinics for reasons different that LUTS (controls); post-operative controls and uncontrolled insulin-dependent-diabetes being excluded.A Case-Report-Form comprehended history, urinalysis, bladder diary, flowmetry/PVR and a final clinician's judgment. Acceptability of ICIQ-CLUTS children and ICIQ-CLUTS parents were evaluated as percentage of missing items. ICIQ-CLUTS children and ICIQ-CLUTS parents scores were matched to clinician's judgement (taken as gold standard) in order to produce sensitivity and specificity (confidence interval 5-10%; level of confidence 95%). Results A total of 345 questionnaires were completed (267 by children and parents, 75 by parents and 3 by children). Final clinician's judgement identified 197 children as LUTS+ and the remaining 148 as LUTS-. Low percentage of missing items confirmed acceptability of ICIQ-CLUTS children (average missing items:1.7%) and ICIQ-CLUTSparents (average missing items:2.0).Sensitivity and specificity were, respectively,85% and 81% for ICIQ-CLUTS children and 87% and 70% for ICIQ-CLUTS parents. Conclusions Data analysis confirms ICIQ-CLUTS as valid and easy tool to screen LUTS in general paediatric population. ICIQ-CLUTS might be used to reconfigurate prevalence of LUTS in children, which was previously evaluated without validated instruments.