Self-Reported Urinary Incontinence, Voiding Frequency, Voided Volume And Pad Test Results: Variables In A Prospective Study In Children

Main Category: Urology / Nephrology
Also Included In: Pediatrics / Children's Health;  Clinical Trials / Drug Trials
Article Date: 11 Nov 2007 - 0:00 PDT

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UroToday.com- A study published in the British Journal of Urology by Bael, et al. prospectively evaluated the self-reported and objective data on incontinence, voided volume, and voiding frequency in children with dysfunctional voiding.

Overall, 202 children were enrolled in what was called the European Bladder Dysfunction Study (EBDS). It provided self-reported data on urinary incontinence, voided volume, and voiding frequency before and after treatment with validated questionnaires and 72-hour voiding diaries. Objective data were obtained with uroflows and a 12-hour pad test done before and after treatment as well. The uroflows were combined with all scheduled office visits.

At the first visit, parents under-reported urinary incontinence on the questionnaires in 45% of cases when compared with the urologist's scores. They found that the sensitivity for the 12-hour pad test for urinary incontinence was only 64%. They also found that the voiding diaries had inconsistent entries on urinary incontinence and on voided volumes. Voiding frequency was overestimated in the questionnaires and underestimated in the diaries when the urologists compared the scores. They found that a voiding frequency of greater than 7 times per day decreased significantly after treatment, but with no correlation with treatment outcome. They also found that the mean voided volume increased significantly after treatment for urinary incontinence, but also showed no correlation with treatment outcome.

The study concluded that voiding diaries and questionnaires are useful tools for charting individual treatment and for screening, but they may not be the best modality for documenting outcome variables in dysfunctional voiding because of over- and under-reporting. Voided volume and voiding frequency also lack specificity when it comes to outcome variables in children with dysfunctional voiding. The group concluded that the 12-hour pad test is not sensitive at all in the self assessment portion of the care of these children. It seemed that the role of the urologist was critical to decipher the complaints and self reporting of symptoms in these children.

Bael AM, Lax H, Hirche H, Gäbel E, Winkler P, Hellström AL, van Zon R, Janhsen E, Güntek S, Renson C, van Gool JD.

The British Journal of Urology. 100(3): 651-656, September 2007
doi:10.1111/j.1464-410X.2007.06933.x
Reported by UroToday.com Contributing Editor Pasquale Casale, M.D

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