Brosula Raphael James, Venkatapuram Pranaya, Chen Abby L, Zhang Chiyuan A, Kan Kathleen M
Department of Urology, Stanford University School of Medicine, Palo Alto, CA, United States.
Front Urol. 2025 Apr 16;5:1422897. doi: 10.3389/fruro.2025.1422897. eCollection 2025.
Pediatric lower urinary tract symptoms (LUTS) impact a significant number of children and families worldwide. Estimated prevalences rely on small cross-sectional studies, leading to inconsistent estimates. This study aims to characterize demographic and temporal trends in LUTS prevalence within a national claims database of privately insured individuals in the United States.
We conducted a retrospective cohort study by reviewing the Merative™ MarketScan Outpatient Research Database v2.0 between 2007-2016. Patients with neurogenic bladder, renal transplant, structural urologic disease, and concurrent urinary tract infection were excluded. Yearly trends were reviewed across age, sex, geographic region, and clinical comorbidities such as attention-deficit/hyperactivity disorder (ADHD) and constipation. Yearly frequency of diagnostic codes was calculated to characterize LUTS diagnostic coding practices.
We identified 1,625,538 patients aged 5-18 years with LUTS, representing 6% of the total population at risk, with a median age of 8.0 years. More patients in the cohort were female (66.1%), between 5-10 years old (57.9%), and resided in the Southern US (38.5%). The yearly prevalence of LUTS significantly increased from 1.8% to 2.1% yearly, and saw significant increases in females, 15-18 year old patients, and across several geographic regions. Comorbid constipation and ADHD within LUTS patients also significantly increased. Diagnostic coding practices remained stable.
Families of patients with LUTS are increasingly seeking medical care for their condition. These results exceed similar estimates from previous longitudinal studies and can inform population-level intervention strategies. Further studies should investigate the impact of LUTS on healthcare resource utilization, including in non-privately insured populations.
小儿下尿路症状（LUTS）影响着全球大量儿童及其家庭。估计患病率基于小规模横断面研究，导致估计结果不一致。本研究旨在描述美国全国私营保险个体索赔数据库中LUTS患病率的人口统计学和时间趋势。
我们通过回顾2007年至2016年期间的默克锐™市场扫描门诊研究数据库v2.0进行了一项回顾性队列研究。排除患有神经源性膀胱、肾移植、结构性泌尿系统疾病和并发尿路感染的患者。对年龄、性别、地理区域以及诸如注意力缺陷多动障碍（ADHD）和便秘等临床合并症的年度趋势进行了回顾。计算诊断编码的年度频率以描述LUTS诊断编码实践。
我们确定了1,625,538名年龄在5至18岁之间患有LUTS的患者，占总风险人群的6%，中位年龄为8.0岁。队列中女性患者更多（66.1%），年龄在5至10岁之间（57.9%），且居住在美国南部（38.5%）。LUTS的年度患病率从每年1.8%显著增加到2.1%，在女性、15至18岁患者以及多个地理区域均有显著增加。LUTS患者中合并便秘和ADHD的情况也显著增加。诊断编码实践保持稳定。
LUTS患者的家庭越来越多地为其病情寻求医疗护理。这些结果超过了先前纵向研究的类似估计，可为人群层面的干预策略提供参考。进一步的研究应调查LUTS对医疗资源利用的影响，包括非私营保险人群。
