The importance of quantitative evaluation of constipation in children with lower urinary tract dysfunction.

Objective: There is a known association between lower urinary tract dysfunction (LUTD) and constipation. The objective of this study was to investigate any correlation between voiding and bowel symptoms in children with LUTD.

Methods: Children presenting with LUTD to our pediatric urology unit were prospectively included. Demographic data were recorded. All patients filled out the "Pediatric Lower Urinary Tract Symptom Score" (P-LUTSS) and "Constipation and Fecal Incontinence Symptom Severity" (CFISS) questionnaires. Symptom score correlation and associations with clinical findings were evaluated.

Results: 76 patients were included. The mean P-LUTSS was 11±7.1; mean CFISS was 7.7±7.5. According to P-LUTSS risk groups, median CFISS score increased as the risk group was increased. There was direct correlation between P-LUTSS and CFISS for all patients. 6, 7, 8, 9, 10 and 13 questions of P-LUTSS were correlated with CFISS; the 1 and 7 questions of CFISS were correlated with P-LUTSS. Patients who responded not to have constipation on P-LUTSS had lower CFISS scores compared to those who had constipation. Patients who had a 0 score on CFISS had a mean P-LUTSS of 7.7±6.2, which put the majority of patients in low-risk group. Also, out of these 11 patients, 10 of them responded to have no constipation on P-LUTSS.

Conclusion: A relationship between LUTD and bowel symptoms, as well as the positive correlation between P-LUTSS and CFISS was demonstrated in this study. Patients presenting with LUTD should undergo meticulous evaluation using special questionnaires for bowel symptoms. Only by then, a complete treatment approach can be provided.