Department of Urology, Division of Pediatric Urology, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, the Netherlands.
Department of Medical Psychology, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, the Netherlands.
J Pediatr Urol. 2021 Dec;17(6):759.e1-759.e8. doi: 10.1016/j.jpurol.2021.08.020. Epub 2021 Sep 3.
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.
儿童下尿路功能障碍（LUTD）可能会影响其日后的下尿路功能和心理健康。本研究旨在比较接受过儿童 LUTD 治疗的青少年和年轻成年人与健康年龄匹配的对照组的长期功能结局、心理结局和生活质量（QOL）。此外，还评估了与过去治疗结果的相关性。
这是一项单中心的回顾性病例对照研究，研究对象为曾在儿童期（目前 16-26 岁）接受治疗的患者。参与者完成了一份由经过验证的问卷组成的调查：膀胱过度活动症问卷、医院焦虑和抑郁量表、儿科生活质量量表和简明健康调查问卷。
52 名曾接受治疗的患者（133 名患者中的 52 名）同意参与并返回了调查问卷（平均年龄 21 ± 4.1 岁）。纳入了 69 名对照者（平均年龄 21 ± 2.9 岁）。与对照组相比，前者更常出现尿路症状。更常报告的储存症状为（急迫性）尿失禁、压力性尿失禁（SUI）和夜尿症。更常报告的排尿症状为间歇性和不完全排空感，图 1。根据儿童期治疗结果（完全缓解、部分缓解或无缓解），分别在尿路症状或尿失禁亚组中，结果无差异（分别为 p = 0.17 和 p = 0.58）。膀胱过度活动症问卷的结果显示，前者的尿路症状困扰评分更高（评分 14 分比 5 分，p < 0.01），疾病特异性 QOL 评分更低（评分 95 分比 98 分，p = 0.02）。两组之间的一般 QOL 和心理社会健康状况无显著差异。儿童期治疗时间延长 2.5 年是日后发生下尿路症状的独立预后因素（OR = 1.5，95%CI 1.1-2.0）。与对照组相比，前者更常出现心理合并症（35%比 10%，p < 0.01）。
接受过儿童 LUTD 治疗的青少年和年轻成年人日后更易发生尿路症状，尤其是治疗时间较长时。然而，日后的一般 QOL 和心理社会健康状况并未受到影响，或仅受到轻度影响。
