Lower Urinary Tract Symptoms in Obese Children

Yıl 2022, , 672 - 681, 29.09.2022

Nuran Cetın , Nadide Melike Sav , Gonca Kılıç Yıldırım

https://doi.org/10.20515/otd.1005482

Öz

Lower urinary tract symptoms (LUTS) is very common in childhood. We aimed to investigate the frequency of LUTS in obese, overweight and normal children using voiding dysfunction symptom score validated for Turkish children by Akbal and et al. The children older than five-years-old who were followed in Pediatric Nutrition and Metabolism Outpatient Clinic were included. Children with a body mass index above the 95th percentile were classified as obese. The symptom score was administered face to face to each child and their mothers together. A score ≥9 was defined as lower urinary tract dysfunction (LUTD). A 164 children (62 obese, 52 overweight, 50 normal) were included. Symptom score was significantly higher in obese children than in overweight and normal weight children. (p=0.004, p=000, respectively). Overweight children had higher symptom score than in normal weight children (p=0.037). The frequency of daily urinary incontinence was higher in obese than overweight and normal weight children (p=0.041, p=0.000, respectively). The both obese and overweight children had higher frequencies of urgency and increased urinary frequency than in children with normal weight (p=0.002, p=0.021 for urgency, p=0.000, p=0.037 for increased urinary frequency, respectively). The frequencies of voiding postponement and constipation were higher in the obese children than those of overweight and normal weight (p=0.000, p=0.000 for voiding postponement, p=0.031, p=0.028 for constipation respectively). Obesity is a significant risk factor for LUTD. The questioning LUTS using questionnaire validated by Akbal et al in obese children can help in the early diagnosis of LUTD.

Anahtar Kelimeler

Children, lower urinary tract symptoms, obesity, voiding dysfunction symptom score

Obez Çocuklarda Alt Üriner Sistem Semptomları

Öz

Alt üriner sistem semptomları (AÜSS) çocukluk çağında oldukça yaygındır. Biz Akbal ve arkadaşları tarafından Türk çocukları için valide edilmiş işeme disfonksiyonu semptom skorunu kullanarak obez, fazla ve normal kilolu çocuklarda AÜSS sıklığını araştırmayı amaçladık. Çocuk Beslenme ve Metabolizma Polikliniği'nde takip edilen beş yaş üstü çocuklar çalışmaya dahil edildi. Vücut kitle indeksi 95 persentilin üzerinde olan çocuklar obez olarak sınıflandırıldı. Semptom skoru her çocuğa ve annesine yüz yüze birlikte uygulandı. Semptom skoru ≥9 olması alt üriner sistem disfonksiyonu (AÜSD) olarak tanımlandı. Çalışmaya 164 çocuk (62 obez, 52 kilolu, 50 normal) dahil edildi. Obez çocuklarda semptom skoru, aşırı kilolu ve normal kilolu çocuklara göre anlamlı olarak daha yüksekti (sırasıyla p=0,004, p=000). Fazla kilolu çocukların semptom skoru normal kilolu çocuklara göre daha fazla idi (p=0.037). Obezlerde günlük idrar kaçırma sıklığı fazla kilolu ve normal kilolu çocuklara göre daha yaygındı (sırasıyla p=0,041, p=0,000). Hem obez hem de fazla kilolu çocuklarda normal kilolu çocuklara göre daha yüksek aciliyet sıklığı ve artmış idrar sıklığı vardı (sırasıyla, aciliyet için p=0,002, p=0,021, idrar sıklığı artışı için p=0,000, p=0,037). İşemeyi erteleme ve kabızlık sıklıkları obez çocuklarda fazla kilolu ve normal kilolu çocuklara göre daha yüksek bulundu (sırasıyla p=0.000, p=0.000 işemeyi erteleme, p=0.031, p=0.028 kabızlık). Obezite AÜSD için önemli bir risk faktörüdür. Obez çocuklarda Akbal ve arkadaşları tarafından doğrulanan anket kullanılarak AÜSS'nin sorgulanması AÜSD'nin erken teşhisine yardımcı olabilir.

Anahtar Kelimeler

Çocukluk, alt üriner sistem semptomları, obezite, işeme disfonksiyonu semptom skoru.

Kaynakça

• Reference1 Hooman N, Hallaji F, Mostafavi SH et al. Correlation between Lower Urinary Tract Scoring System, Behavior Check List, and Bladder Sonography in Children with Lower Urinary Tract Symptoms. Korean J Urol. 2011;52:210-5.
• Reference2 Harari MD, Moulden A. Nocturnal enuresis: what is happening? J Paediatr Child Health. 2000;36:78-81.
• Reference3 Akbal C, Genc Y, Burgu B et al. Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. J Urol. 2005;173:969-73.
• Reference4 Oliver JL, Campigotto MJ, Coplen DE et al. Psychosocial comorbidities and obesity are associated with lower urinary tract symptoms in children with voiding dysfunction. J Urol. 2013;190:1511-5.
• Reference5 Neyzi O, Bundak R, Gökçay G et al. Reference Values for Weight, Height, Head Circumference, and Body Mass Index in Turkish Children. J Clin Res Pediatr Endocrinol. 2015;7:280-93.
• Reference6 Austin PF, Bauer S, Bower W et al. The standardization of terminology of bladder function in children and adolescents: update report from the Standardization Committee of the International Children’s Continence Society (ICCS). Neurourol Urodyn. 2016;35:471–81.
• Reference7 Rasquin A, Di Lorenzo C, Forbes D et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology. 2006;130:1527-37.
• Reference8 Vaz GT, Vasconcelos MM, Oliveira EA et al. Prevalence of lower urinary tract symptoms in school-age children. Pediatr Nephrol. 2012;27:597-603.
• Reference9 Farhat W, Bagli DJ, Capolicchio G et al. The dysfunctional voiding scoring system: quantitative standardization of dysfunctional voiding symptoms in children. J Urol. 2000;164:1011-5.
• Reference10 Schneider D, Yamamoto A, Barone JG. Evaluation of consistency between physician impression and 3 validated survey instruments for measuring lower urinary tract symptoms in children. J Urol. 2011;186:261-5.
• Reference11 Yüksel S, Yurdakul AÇ, Zencir M et al. Evaluation of lower urinary tract dysfunction in Turkish primary schoolchildren: an epidemiological study. J Pediatr Urol. 2014;10:1181-6.
• Reference12 Erdem E, Lin A, Kogan BA et al. Association of elimination dysfunction and body mass index. J Pediatr Urol. 2006;2:364-7.
• Reference13 Cummings JM, Rodning CB. Urinary stress incontinence among obese women: review of pathophysiology therapy. Int Urogynecol J Pelvic Floor Dysfunct. 2000;11:41-4.
• Reference14 Fraga LGA, Sampaio A, Boa-Sorte N et al. Obesity and lower urinary tract dysfunction in children and adolescents: Further research into new relationships. J Pediatr Urol. 2017;13:387.e1-e6.
• Reference15 Austin PF, Bauer SB, Bower W et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children’s Continence Society. J Urol. 2014;191:1863-5.
• Reference16 Franco I. Overactive bladder in children. Nat Rev Urol. 2016;13:520-32.
• Reference17 Chang SJ, Chiang IN, Lin CD et al. Obese children at higher risk for having overactive bladder symptoms: a community-based study. Neurourol Urodyn. 2015;34:123–7.
• Reference18 Wang SG, Yang SS, Chang SJ. Association Between Obesity and Lower Urinary Tract Symptoms Among Children and Adolescents: A Community-Based Study. Front Pediatr. 2021;9:609057.
• Reference19 Franco I. Functional Bladder Problems in Children. Pediatr Clin N Am. 2012;59:783–817.
• Reference20 Rudaitis Pundziene B, Jievaltas M, Uktveris R et al. Recurrent urinary tract infection in girls: do urodynamic behavioral and functional abnormalities play a role. J Nephrol. 2009;22:766–3.
• Reference21 Lettgen B, von Gontard A, Olbing H et al. Urge incontinence and voiding postponement in children: somatic and psychosocial factors. Acta Paediatr. 2002;91:978–84.
• Reference22 Vo M, Lau J, Rubinstein M. Eating disorders in adolescent and young adult males: presenting characteristics. J Adolesc Health. 2016;59:397-400
• Reference23 Molyneaux E, Pasupathy D, Kenny LC et al. SCOPE consortium. Socio-economic status influences the relationship between obesity and antenatal depression: data from a prospective cohort study. J Affect Disord. 2016;202:124-7.
• Reference24 Freedman DS, Dietz WH, Srinivasan SR et al. The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics. 1999;103:1175–82.
• Reference25 Sagi R, Reif S, Neuman G et al. Nonalcoholic fatty liver disease in overweight children and adolescents. Acta Paediatr. 2007;96:1209–13.
• Reference26 Delgado-Aros S, Locke GR III, Camilleri M et al. Obesity is associated with increased risk of gastrointestinal symptoms: a population-based study. Am J Gastroenterol. 2004;99:1801–6.
• Reference27 Fishman L, Lenders C, Fortunato C, Noonan C, Nurko S. Increased prevalence of constipation and fecal soiling in a population of obese children. J Pediatr. 2004;145:253–254.
• Reference28 Koppen IJ, Velasco-Benítez CA, Benninga MA et al. Is There an Association between Functional Constipation and Excessive Bodyweight in Children? J Pediatr. 2016;171:178-82.
• Reference29 Pieramico O, Malfertheiner P, Nelson DK et al. Interdigestive gastroduodenal motility and cycling of putative regulatory hormones in severe obesity. Scand J Gastroenterol. 1992;27:538-44.
• Reference30 Van Der Sijp JRM, Kamm MA, Nightingale JMD et al. Circulating gastrointestinal hormone abnormalities in patients with severe idiopathic constipation. Am J Gastroenterol. 1998;93:1351-6.
• Reference31 Taylor MJ, Vlaev I, Taylor D et al. Cardiac autonomic regulation as a predictor for childhood obesity intervention success. Int J Obes (Lond). 2017;41:824-7.