Is There Any Difference between Questionnaires on Pediatric Lower Urinary Tract Dysfunction ?

To investigate diagnostic properties of 3 different scoring systems [Dysfunctional Voiding Symptom Score (DVSS), Dysfunctional Voiding and Incontinence Symptoms Score (DVISS), Incontinence Symptom Index-Pediatric (ISI-P, for children older than 11 years)] which are used to evaluate lower urinary tract symptoms in pediatric population.

Eighty-four participants were evaluated by detailed history, physical examination, 3 different scoring systems (DVSS, DVISS, ISI-P), ultrasonography and uroflowmetry. Depending on the tests, cases were stratified as healthy or lower urinary tract symptoms (LUTS) by 2 urologists who were blinded to the questionnaires. Patients were re-evaluated by the same tests and questionnaires 3 months after treatment. Diagnostic properties of questionnaires were calculated. Additionally, parents were asked to scale the improvement of symptoms subjectively from 0 to 100% in order to correlate to each three scoring systems.

Mean age of normal and LUTD groups were 9.1±2.6 years and 10.1±2.8 years, respectively (p=0.301). Gender (male/female) distribution was 21/21 in LUTD group and 25/17 in control group (p=0.381). In terms of diagnosis, DVISS has the highest accuracy (sensitivity:81%, spesificity:97.6%, accuracy:89%) followed by ISIP (sensitivity:55.6%, specificity:100%, accuracy:82%) and DVSS (sensitivity: 54.8%, specificity: 97.6%, accuracy:76%). The similar order was valid for the 23 patients older than 11 years (accuracy for DVISS:87%, ISIP:82%, DVSS:78%). In terms of response to treatment, all three tests showed good correlation with parents' ratings (DVSS:p<0.001, DVISS:p=0.005, ISIP:p=0.042).

Although, DVISS had the highest accuracy in distinguishing the patients from healthy controls, all three questionnaires seem to be equivalent for the evaluation of response to treatment.

Urology. 2017 Jan 09 [Epub ahead of print]

Mesut Altan, Burak Çitamak, Ali Cansu Bozaci, Emin Mammadov, Hasan Serkan Doğan, Serdar Tekgül

Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, 06100 Sıhhıye ANKARA/TÜRKİYE.