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Bladder/bowel dysfunction at school age is seen in children with high-grade vesicoureteral reflux and lower urinary tract dysfunction in infancy

Journal article
Authors Sofia Sjöström
Helena Ekdahl
Kate Abrahamsson
Ulla Sillén
Published in Acta Paediatrica
Volume 109
Issue 2
Pages 388-395
ISSN 0803-5253
Publication year 2020
Published at Institute of Clinical Sciences
Pages 388-395
Language en
Links dx.doi.org/10.1111/apa.14973
Keywords bladder, bowel dysfunction, dysfunctional voiding, follow-up from infancy, vesicoureteral reflux, voiding dysfunction, infection, trial, Pediatrics
Subject categories Pediatrics

Abstract

Aim In approximately one third of cases, congenital high-grade vesicoureteral reflux (VUR) diagnosed during infancy is seen together with lower urinary tract dysfunction (LUTD), characterised by a high-capacity bladder and incomplete emptying. In an earlier study, 20 of these infants were treated with clean intermittent catheterisation during a 3-year period and with surgical treatment of the VUR before catheterisation was ended. In the present study, bladder function was evaluated in these children at school age. Methods Bladder function was evaluated in the 20 children at a mean age of 7.3 years using a validated voiding-bowel questionnaire with scores (cut-off score 7) and a urine flow/residual study. Results Four children (20%) had a normal voiding function at follow-up, whereas 11 (55%) had a clear bladder/bowel dysfunction (scores 7-19) and five (25%) had a mild dysfunction (score 6). Ten (63%) of the children with any dysfunction were recognised as dysfunctional voiding. Recurrent febrile urinary tract infections were correlated with the scores of faecal questions (P = .041), but for total scores P = .058. Conclusion The follow-up of bladder function in children at 7.3 years, diagnosed with high-grade VUR and LUTD in infancy, revealed bladder/bowel dysfunction of varying severity in the majority of cases.

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