PURPOSE: To assess the prevalence of functional defecation disorders (FDD) such as functional constipation (FC) and functional nonretentive fecal incontinence (FNRFI) in children referred to a tertiary pediatric urology outpatient clinic for lower urinary tract symptoms (LUTS).
MATERIAL AND METHODS:A chart review was performed in patients aged 4-17 years being evaluated because of LUTS. All patients received a standardized bowel questionnaire and physical examination. The prevalence of pediatric FDD according to the Rome criteria was assessed. A transabdominal ultrasound (US) was performed measuring the rectal diameter. A rectal diameter of > 3 cm was considered as indicative of a rectal fecal mass.
RESULTS: 113 patients with LUTS (median age 8 years (interquartile range 6-10 years, 50 boys) were analyzed. Among these patients, 46 had dysfunctional voiding (DV) and 38 urge-incontinence/overactive bladder. 47% and 11% of patients with LUTS fulfilled the Rome criteria for FC and FNRFI, respectively. Children with DV more likely fulfilled the Rome criteria (63%) for FC than children with urge-incontinence (42%) and other urological disorders (28%) (p 0.009). Children with urge-incontinence more likely fulfilled the Rome criteria for FNRFI (21%) than children with DV (2.2%) and other urological disorders (10%) (p 0.02).
CONCLUSION: More than 50% of children with LUTS evaluated in a tertiary referral center fulfill diagnostic criteria for FDD. We recommend evaluation of bowel habits as part of the initial assessment of a child presenting with urological symptoms. Future studies regarding the effect of treatment of FDD on urological symptoms are justified.
Written by:
Burgers R, de Jong TP, Visser M, Di Lorenzo C, Dijkgraaf MG, Benninga MA. Are you the author?
Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands; Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands.
Reference: J Urol. 2012 Oct 30. pii: S0022-5347(12)05352-9.
doi: 10.1016/j.juro.2012.10.064
PubMed Abstract
PMID: 23123369
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