Çocuklarda alt üriner sistem disfonksiyonu tanısı için klinik kriterler

Abstract

Objective: Functional urinary incontinence can be diurnal, nocturnal, or diurnal and is a manifestation of the lower urinary tract dysfunction (LUTD). The aim of this study is to determine non-invasive clinical criteria that can be used in the diagnosis of LUTD. Material and Methods: Ninety-four patients with functional urinary incontinence, whose medical records were followed in the pediatric nephrology clinic, were included in the study. Patients were evaluated retrospectively, descriptively, and analytically. Results: Fifty-one patients (54.3%) had overactive bladder (OAB), and 11 had dysfunctional voiding (DI). Frequent voiding symptoms, urgency, and holding maneuvers were more common in the OAB and AAB-DI groups, while straining and intermittency was more common in the DI group. The combination of holding maneuvers and maximum voiding volume findings in OAB cases was found to have high sensitivity for diagnosis. According to the voiding chart, the diagnosis of OAB was found in 82.4% of patients with a mean voiding volume/expected bladder capacity ratio below 50%, with more than seven voiding complaints and findings of holding maneuvers. The relationship between the absence of urge symptoms, intermittent voiding, and the detection of PVR for DI was significant and sensitive. Dysfunctional voiding was diagnosed in 82.8% of the patients with intermittent voiding complaints, no symptoms of urgency, and significant PVR on ultrasonography. Conclusion:The OAB group constitutes a significant portion of LUTD patients. The diagnosis of OAB can be considered in cases with positive urgency and holding maneuvers, with no PVR on ultrasonography, whose maximum volume is less than 50% of the expected bladder capacity in the voiding frequency-volume chart, whose daily voiding number is above seven, and whose holding maneuvers are positive. Dysfunctional voiding prediagnosis can be predicted in cases with PVR and complaints such as intermittent voiding and urinating by straining, generally with a low number of voidings.