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POSTVOIDAL RESIDUAL URINE IS THE SINGLE PROGNOSTIC FACTOR TO
PREDICT THE TREATMENT OUTCOME IN CHILDREN WITH LOWER URINARY
TRACT DYSFUNCTION
Alp Tuna BEKSAC, Ali Cansu BOZACI, Artan KONI, Hasan Serkan DOGAN and Serdar TEKGUL
Hacettepe University, Urology, Ankara, TURKEY
PURPOSE
To investigate the prognostic values of noninvasive diagnostic tools (uroflowmetry, postvoiding residue measurement,
dysfunctional voiding and incontinence symptom scale(DVISS), urinary ultrasound) on the response of lower urinary
tract dysfunction treatment.
MATERIAL AND METHODS
We analyzed the data of 116 patients between ages of 5-14, who were treated for voiding dysfunction from November
2006 to September 2013 retrospectively. All patients with neurogenic conditions were excluded from the study. DVISS
questionnaire was filled by patients' parents. In addition, uroflowmetry, post voiding residual urine(PVR) measurement
and urinary tract ultrasound were performed. All patients received urotherapy as primary treatment. In addition, some
patients were treated with pharmacotherapy and/or other treatment options. During follow-up(mean 7,27 months),
DVISS, uroflowmetry, PVR and urinary ultrasound tests were repeated.
RESULTS
Mean age value was 7.68 years. Mean follow up period was 7.27 months. Type or number of complaints(p=0,0736 and
p=1,000 respectively), age(p=0,884), UTI status(p=1,000), bladder wall thickness(p=0,514),
hydronephrosis(p=0,776), uroflowmetry pattern(p=0,653), constipation(P=0,678) and DVISS(p=0,321) were not found
to have any significant effect to predict the treatment outcome. The pretreatment presence of residual urine more than
10% of expected bladder capacity was the single prognosic factor (p=0.041). DVISS improvement was worse amongst
the patients who had increased PVR(75%), as opposed to the patients who hadn’t(%93,9).
CONCLUSIONS
Non-invasive diagnostic tools are sufficient in first line evaluation of children with voiding dysfunction. Amongst these
tests, presence of post voiding residual urine is the single risk factor for worse prognosis.