Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada; Faculty of Art & Science, University of Toronto, Ontario, Canada.
Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada.
J Pediatr Urol. 2021 Aug;17(4):450.e1-450.e6. doi: 10.1016/j.jpurol.2021.03.032. Epub 2021 Apr 3.
Bladder and bowel dysfunction (BBD) is a common pediatric problem that describes a constellation of lower urinary tract symptoms associated with constipation and/or encopresis. Its association with neurodevelopmental and psychiatric (NDP) problems is not well understood.
Our primary aim was to identify pre-existing NDP disorders in children with BBD. Secondarily, we aimed to screen for new behavioral problems and evaluate the association between bladder or bowel symptoms and behaviors symptoms.
A cross sectional study was conducted in urology clinics. New patients referred for BBD between 4 and 17 years old were recruited and completed: a demographics survey, Dysfunctional Voiding Score System questionnaire, assessment of bowel movements with the Bristol Stool Scale, and Strength and Difficulties questionnaire (SDQ). Those with known spinal dysraphism were excluded. SDQ scores were evaluated for abnormal screens in different subscales and total difficulties scores. Pearson correlation analyses were conducted for association.
We included 61 participants (age 9.5 ± 4.1 years), including 33 females and 28 males. One or more pre-existing NDP disorder(s) was reported in 14 (23%) children; most commonly being learning disability (43%) and attention deficit hyperactivity disorder (29%). This cohort had more severe BBD symptoms as reflected in DVSS scores. SDQ scores demonstrated that 12 patients without pre-existing NDP diagnoses scored in the clinical range, with hyperactivity as the most common difficulty (6/12; 50%).
A significant proportion of children with BBD have a comorbid NDP disorder and present with more severe symptomatology. The SDQ can be used as a behavioral screening tool this population for the identification of children who may benefit from formal developmental pediatrics assessment.
膀胱和肠道功能障碍（BBD）是一种常见的儿科问题，描述了一系列与便秘和/或粪便嵌塞相关的下尿路症状。它与神经发育和精神（NDP）问题的关系尚不清楚。
我们的主要目的是确定患有 BBD 的儿童是否存在先前存在的 NDP 障碍。其次，我们旨在筛查新的行为问题，并评估膀胱或肠道症状与行为症状之间的关系。
在泌尿科诊所进行了一项横断面研究。招募了年龄在 4 至 17 岁之间因 BBD 就诊的新患者，并完成了以下内容：人口统计学调查、排尿功能障碍评分系统问卷、使用布里斯托粪便量表评估排便情况以及困难问题问卷（SDQ）。排除已知脊柱发育不良的患者。评估 SDQ 分数在不同子量表和总困难分数中是否存在异常筛查。进行 Pearson 相关分析以评估关联。
我们纳入了 61 名参与者（年龄 9.5 ± 4.1 岁），包括 33 名女性和 28 名男性。14 名（23%）儿童报告存在一种或多种先前存在的 NDP 障碍，最常见的是学习障碍（43%）和注意力缺陷多动障碍（29%）。该队列的 BBD 症状更为严重，反映在 DVSS 评分上。SDQ 评分显示，12 名无先前存在的 NDP 诊断的患者得分处于临床范围内，多动为最常见的困难（6/12；50%）。
相当一部分患有 BBD 的儿童存在共患的 NDP 障碍，并表现出更为严重的症状。SDQ 可作为该人群的行为筛查工具，用于识别可能受益于正规发育儿科评估的儿童。
