Voiding Pattern of Toilet-Trained Filipino Children With Recurrent Urinary Tract Infection and Without Urinary Tract Infection
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Keywords

recurrent urinary tract infection
dysfunctional voiding symptoms score
DVSS

How to Cite

Lim, A. ., & Bolong, D. (2020). Voiding Pattern of Toilet-Trained Filipino Children With Recurrent Urinary Tract Infection and Without Urinary Tract Infection. Philippine Journal of Urology, 28(1), 32-39. Retrieved from https://pjuonline.com/index.php/pju/article/view/62

Abstract

Objectives: The objectives of this study were to compare the voiding pattern of toilet-trained patients with and without recurrent UTI, to describe the voiding pattern of toilet-trained patients without UTI aged 2 to 15 years old and to describe the voiding pattern of toilet trained patients with recurrent UTI aged 2 to 15 years old.

Materials and Methods: A total of 80 toilet-trained Filipino children divided into two groups with 40 each were included. R-UTI group consisted of patients aged 2 to 15 years old who presented with recurrent UTI. The control (No-UTI) group consisted of children aged 2 to 15 years old without any urinary symptoms and without history of urinary tract infection. Parents completed a 72-hour bladder chart at home. All participants answered Farhat's DVSS. Patients underwent uroflowmetry, uroflowmetry with EMG and post void residual assessment (PVR). Qmax, uroflowmetry pattern, bladder wall thickness and PVR were recorded and analyzed using independent t-test.

Results: The mean age of subjects with UTI was 6.32 ± 2.77 years and those in the control group have a mean age 6.67 ± 2.77 years old. Of patients of R-UTI group the following were statistically significant compared to No-UTI : Constipation (48% vs 15%), mean frequency of voiding volumes greater than 125% of the estimated bladder capacity (EBC) at daytime (0.8 ± 0.22 vs 0.05 ± 1.20 p=0.0002), frequency (45% vs 5%), mean average voided volume (126.54 ± 56.05 mL vs 84.34 ± 34.26 mL p=0.0001), mean daytime average voided volume (121.33 ± 59.59 mL vs 87.90 ± 36.41 mL p =0.0033), mean maximum voided volume (232.25 ± 113.99 mL vs 130.85 ± 49.99 mL p<0.0001), mean bladder thickness (3.83 ± 0.68 mm vs 3.38 ± 0.62 mm p = 0.0030), mean PVR (12.96 ± 10.54 mL vs 5.21 ± 5.68 mL p=0.0001). PVR was significant in 45% of cases compared to 3% significant PVR (when 4-6 years old defined as >10ml or >10%of EBC, and if >7 years old >20ml or >15% of EBC). When mean PVR was computed as percentage of EBC, R-UTI group had a statistically higher percentage compared to the no-UTI group (6.27 ± 2.52 % vs 2.52 ± 2.75 % p=0.0001). Mean observed bladder capacity (OBC) was found to be more than the EBC in 35% of cases in the R-UTI group compared to 12% of No-UTI group (p=0.018). Uroflow-EMG in the RUTI group were, 85% synergic, 12% dyssynergic and 3% interrupted pattern. EMG in the No-UTI group were, 38% synergic, 55% dyssynergic, 2% delayed relaxation, 5% interrupted. The EMG patterns were statistically significant between the groups (p<0.0001). Uroflow patterns were comparable between the two groups (p=1.000).

Conclusion: Constipation was more frequent in the R-UTI group. R-UTI group had a higher mean frequency of EBC > 125% during daytime, frequency, mean average voided volume, mean average voided volume during daytime, mean maximum voided volume, mean bladder thickness, mean PVR compared to the without UTI group. Mean observed bladder capacity was observed to be greater than the EBC in the R-UTI group compared to the No-UTI group. R-UTI group was synergic compared to No-UTI group which were dyssynergic.

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