The Prevalence and Therapeutic Effect of Constipation in Pediatric Overactive Bladder
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: Overactive bladder (OAB) is a manifestation of urgency, regardless of urge incontinence, due to involuntary bladder contraction during the storage period. There is a close association between constipation and OAB, but constipation cannot be readily diagnosed. The aims of this study were to evaluate the prevalence of constipation in OAB and the consequent therapeutic effects according to the diagnostic criteria for constipation. Methods: We collected clinical data from 40 children (mean age, 71±22 months) with chief complaints of urgency, frequency, and incontinence. A voiding questionnaire and a 2-day voiding diary were collected, and urinalysis, the Bristol stool scale, and plain abdominal radiography were performed. Constipation was defined as conditions satisfying at least one of the following criteria: Rome III diagnostic criteria, Bristol stool scale types I/II, or a Leech score higher than 8 points as determined by plain radiography. Lower urinary tract symptoms, defecation symptoms, and the bladder volume of patients were examined, and the therapeutic outcomes by constipation diagnostic criteria were evaluated. Results: Of the 40 OAB patients, 25 had constipation. Among them, 6 had reduced functional bladder capacity (24%; P>0.05). Regarding treatment, in patients who satisfied only one diagnostic criterion, the symptoms improved in 76.9%, 76.9%, and 69.6% of patients meeting the Rome III criteria, Bristol stool scale, and Leech score, respectively (P<0.05). Among the 8 patients satisfying all three criteria, 75% responded to treatment (P<0.05). Conclusions: The prevalence of constipation in OAB is high. Constipated patients recruited by use of the Rome III criteria, Bristol scale, and Leech score alone and together showed similar outcomes on OAB improvement after the treatment of constipation, which implies that each criterion has the same strength and can be applied comprehensively and generally.
Abstract
Purpose: Overactive bladder (OAB) is a manifestation of urgency, regardless of urge incontinence, due to involuntary bladder contraction during the storage period. There is a close association between constipation and OAB, but constipation cannot be readily diagnosed. The aims of this study were to evaluate the prevalence of constipation in OAB and the consequent therapeutic effects according to the diagnostic criteria for constipation. Methods: We collected clinical data from 40 children (mean age, 71±22 months) with chief complaints of urgency, frequency, and incontinence. A voiding questionnaire and a 2-day voiding diary were collected, and urinalysis, the Bristol stool scale, and plain abdominal radiography were performed. Constipation was defined as conditions satisfying at least one of the following criteria: Rome III diagnostic criteria, Bristol stool scale types I/II, or a Leech score higher than 8 points as determined by plain radiography. Lower urinary tract symptoms, defecation symptoms, and the bladder volume of patients were examined, and the therapeutic outcomes by constipation diagnostic criteria were evaluated. Results: Of the 40 OAB patients, 25 had constipation. Among them, 6 had reduced functional bladder capacity (24%; P>0.05). Regarding treatment, in patients who satisfied only one diagnostic criterion, the symptoms improved in 76.9%, 76.9%, and 69.6% of patients meeting the Rome III criteria, Bristol stool scale, and Leech score, respectively (P<0.05). Among the 8 patients satisfying all three criteria, 75% responded to treatment (P<0.05). Conclusions: The prevalence of constipation in OAB is high. Constipated patients recruited by use of the Rome III criteria, Bristol scale, and Leech score alone and together showed similar outcomes on OAB improvement after the treatment of constipation, which implies that each criterion has the same strength and can be applied comprehensively and generally.
참고문헌 (19)
- Loening-Baucke V, "Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood", Pediatrics, 100(2 Pt 1), pp.228~232 (1997)
- Chase JW, "Functional constipation in children", J Urol, 171(6 Pt 2), pp.2641~2643 (2004)
- De Wachter S, "Impact of rectal distention on the results of evaluations of lower urinary tract sensation", J Urol, 169, pp.1392~1394 (2003)
- O’Regan S, "Constipation a commonly unrecognized cause of enuresis", Am J Dis Child, 140, pp.260~261 (1986)
- Lewis SJ, "Stool form scale as a useful guide to intestinal transit time", Scand J Gastroenterol, 32, pp.920~924 (1997)
- van den Bosch M, "Systematic assessment of constipation on plain abdominal radiographs in children", Pediatr Radiol, 36, pp.224~226 (2006)
- Hjälmås K, "Micturition in infants and children with normal lower urinary tract. A urodynamic study", Scand J Urol Nephrol, Suppl 37, pp.1~106 (1976)
- Nevéus T, "The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children’s Continence Society", J Urol, 176, pp.314~324 (2006)
- Franco I, "Overactive bladder in children. Part 1: Pathophysiology", J Urol, 178(3 Pt 1), pp.761~768 (2007)
- 문두건, "Prevalence and Associated Factors of Overactive Bladder in Korean Children 5-13 Years Old: A Nationwide Multicenter Study", Urology, 73(1), pp.63~67
- Bannister JJ, "Urological abnormalities in young women with severe constipation", Gut, 29, pp.17~20 (1988)
- Cayan S, "The assessment of constipation in monosymptomatic primary nocturnal enuresis", Int Urol Nephrol, 33, pp.513~516 (2001)
- 김기혁, "외래에서 흔히 접하는 배뇨 증상- 배뇨장애를 중심으로", Korean Journal of Pediatrics, 48(6), pp.575~579 (2005), 대한소아과학회
- Kajiwara M, "Nocturnal enuresis and overactive bladder in children: an epidemiological study", Int J Urol, 13, pp.36~41 (2006)
- 김아영, "소아 배뇨장애 환자에서 변비에 대한 보호자 진술의 의미", Korean Journal of Urology, 49(5), pp.439~442 (2008), 대한비뇨기과학회
- Miyazato M, "Rectal distention inhibits bladder activity via glycinergic and GABAergic mechanisms in rats", J Urol, 171, pp.1353~1356 (2004)
- Rasquin A, "Childhood functional gastrointestinal disorders: child", adolescent, 2006, pp.130, 1527~1537
- Riegler G, "Bristol scale stool form. A still valid help in medical practice and clinical research", Tech Coloproctol, 5, pp.163~164 (2001)
- Koh H, "Simple diagnostic approach to childhood fecal retention using the Leech score and Bristol stool form scale in medical practice", J Gastroenterol Hepatol, 25, pp.334~338 (2010)