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Quality of life, cognitive level and school performance in children with functional lower urinary tract dysfunction

Abstract

Introduction:

Lower urinary tract dysfunction (LUTD) are voiding dysfunctions without anatomical or neurological defects. The diagnosis is primarily clinical, with symptoms standardized by the International Children's Continence Society. Few studies relate quality of life of patients with cognitive and school performance.

Objective:

To evaluate milestones of bladder control, daily problems, quality of life (QoL), cognitive function and school performance of children with LUTD.

Methods:

Case series of patients followed in the Pediatric Nephrology tertiary hospital with assessment of QoL (Pediatric Quality of Life Inventory - PedsQoL version 4), School Performance Test (TDE) and Raven Progressive Matrices test.

Results:

Girls of lower social class were (90.9%) of eligible children. The mean age was 9.1 ± 4.8 years old. The most common symptoms were urge incontinence (81%), holding maneuvers (77.3%) and enuresis (59.1%) associated with the elimination disorder syndrome (63.6%). Caregivers considered volunteers urinary losses and/ or symptoms, and fought and/or beat the child. Children had been subjected to embarrassing situations such as warnings of teachers, they hid symptoms and/or the dirty clothes. Mean score of QoL was 71.0 ± 12.6 with the lowest mean score on the school dimension. In TDE 55% had lower performance and in Raven Matrices 60% were intellectually in the medium level. It was observed lower QoL scores in the medium and lower level of TDE and average intellectual capacity/below average in Raven matrices.

Conclusion:

LUTD may negatively affect family and social relationships, school performance and QoL of children with the dysfunction.

Keywords:
cognitive science; constipation; lower urinary tract symptoms; pediatrics; psychomotor performance; quality of life; underachievement; urinary incontinence

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