The School Context and Lower Urinary Tract Symptoms: An Integrative Literature Review (original) (raw)
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Prevalence of lower urinary tract symptoms in school-age children
Pediatric Nephrology, 2012
Epidemiological studies have demonstrated rates of incontinence and enuresis as high as 20% in school-age children. This cross-sectional study aimed to investigate the prevalence of lower urinary tract (LUT) symptoms in 739 children aged 6-12 years enrolled in three government schools with different socioeconomic levels in Minas Gerais, Brazil. Symptoms of LUT were evaluated using a modified version of the Dysfunction Voiding Scoring System in which the cutoff point considered as an indicator of LUT dysfunction is >6 for girls and >9 for boys. Children with a score indicative of symptoms received an educational booklet on the functioning of the LUT and were sent for clinical evaluation. LUT dysfunction symptoms were detected in 161 (21.8%) children. Symptoms were most frequent in girls (p<0.001), children aged 6-8 (p< 0.028), and attended the school with the lowest social level (p<0.001). Intestinal constipation was the most prevalent finding (30.7%), independent of LUT score. The most common urinary symptoms in children with an elevated score were diurnal urinary incontinence (30.7%), holding maneuvers (19.1%), and urinary urgency (13.7%). Stress factors were associated in 28.4% of children. Our findings suggest that LUT symptoms must be investigated carefully at routine pediatric visits.
Urinary and Intestinal Symptoms in Public Elementary School Children
ESTIMA, Brazilian Journal of Enterostomal Therapy, 2022
Objective: survey the occurrence of urinary and intestinal symptoms in children from public elementary schools in the capital of Paraná. Method: quantitative, exploratory-descriptive and cross-sectional study. Sample of parents/ guardians who completed the following instruments: Dysfunctional Voiding Scoring System; Rome IV criteria; Bristol scale. Analysis performed by IBM SPSS Statistics v.20.0. Data were collected from August to October 2019. Inclusion criteria were the child being enrolled and regularly attending elementary school and the delivery of the completed or partially completed questionnaire. Results: 458 questionnaires were delivered. Of those fully completed, 51.9% were girls, and the age was 7.7 years; 83% of the children had some urinary and/or intestinal symptoms of low severity. There was no significant difference in symptoms between genders, and with a significant increase in severity in children aged 7 years and under. Most prevalent symptoms: reduced voiding fr...
Enuresis, Lower Urinary Tract Dysfunction and Teachers’ Perceptions: A School-based Survey
Indian Pediatrics, 2020
Objective: To determine the prevalence of enuresis and lower urinary tract dysfunction among Indian schoolchildren, and describe teacher perceptions regarding toilet requests. Methods: Anonymous survey of students of a secondary school in Visakhapatnam, India by a modified version of the Dysfunctional voiding and incontinence scoring system (DVISS) in 2518 parents. Two questionnaires-the Bathroom behaviour scale and Teachers' hassle scale for toilet requests were designed, validated and administered to 138 teachers. Results: We received 1911 (75.9%) modified DVISS questionnaires with response; 1790 (93.7%) were valid. History was compatible with enuresis in 85 (4.7%), nonmonosymptomatic enuresis in 38 (2.1%), overactive bladder in 46 children (2.6%), dysfunctional voiding syndrome in 14 children (0.8%) and both overactive bladder as well as dysfunctional voiding syndrome in 4 (0.2%). Responses of 43 (31.2%) teachers indicated refusal of toilet requests; medical cause underlying frequent toilet; requests was understood by 82 (59.4%) teachers. At least one aspect of toilet requests was a frequent or intense hassle in 43 (39.8%) and 29 (28.7%) teachers, respectively. Conclusion: Toilet requests are misunderstood by and present a stressor to a sizeable minority of teachers.
Urology, 2020
To examine whether the school toilet environment at age 13, including bullying at toilets, is associated with female LUTS at ages 13 and 19, as little is known about the association among school toilet environment, voiding behaviors, and lower urinary tract symptoms (LUTS) in adolescent girls. (b) Methods: The sample comprised 3962 female participants from the Avon Longitudinal Study of Parents and Children (ALSPAC). At age 13, participants reported on 7 school toilet environment characteristics and a range of LUTS items. At age 19, participants completed the Bristol Female Lower Urinary Tract Symptoms (ICIQ-BFLUTS) questionnaire. (c) Results: All toilet environmental factors were associated with at least one LUTS outcome at age 13. Holding behavior was associated with all school toilet environmental factors, with odds ratios (ORs) ranging from 1.36 (95% CI: 1.05, 1.76) for dirty toilets to 2.38 (95% CI: 1.60, 3.52) for feeling bullied at toilets. Bullying was associated with all daytime LUTS symptoms and nocturia; ORs ranged from 1.60 (95% CI: 1.04, 2.07) for nocturia to 2.90 (95% CI: 1.77, 4.75) for urgency. Associations between age 13 school toilets and age 19 LUTS were in the same direction as age 13 LUTS. (d) Conclusions: This is the first examination of associations between school toilets and LUTS. Toileting environments were cross-sectionally associated with LUTS in adolescent girls. While further work is needed to determine whether these associations are causal, school toilet environments are modifiable and thus a promising target for LUTS prevention.
European Journal of Pediatrics, 2004
To analyse the risk factors for recurrent urinary tract infection (UTI) and the possible influence of pottytraining, a questionnaire with 41 questions was completed by 4,332 parents of children completing the last 2 years of normal primary school. Statistical analysis was done with the Chi-squared test and Yates correction. Three groups of children emerged: one without any history of UTI (n =3818), a group with one actual or former UTI (n =382) and a group with recurrent UTI (n =132). Mean age was 11.5±0.56 years. A strong correlation between daytime and/or night-time wetting, voiding frequency of more than 10 times a day and nocturia and recurrent UTI was found. No correlation between these factors and a single UTI could be demonstrated. In the 343 bed-wetting children, equal infections for boys and girls were found. Potty-training started significantly earlier in children without UTI. Parents of children with recurrent UTIs insisted more when the first attempt to void was unsuccessful: in the group without UTI, most parents just postponed and had the child try later again. In the group with recurrent UTI, more parents asked the child to strain, made special noises or turned on a tap. Conclusion: Daytime with/without night-time wetting, more than 10 voidings a day and nocturia are indicators of recurrent urinary tract infections. If they are simultaneously present, the relative risk for recurrent urinary tract infections is 60%. Consequently, paediatricians should take urinary symptoms very seriously into account, and as incontinence is still a hidden condition, question the child on this topic.
The Prevalence of Diurnal Urinary Incontinence and Enuresis and Quality of Life: Sample of School
2018
PURPOSE Enuresis can cause loss of self-esteem in children, change relations with family and friends, and decrease the school success. This study was conducted to determine the prevalence of urinary incontinence (UI) in school children aged between 11-14 years and identify the emotions and social problems of enuretic children. MATERIALS AND METHODS A mixed methods approach was used on a group of students who reported UI by combining quantitative data from school population-based cross-sectional design with qualitative data using in-depth interview techniques. The data of this descriptive and cross-sectional study were collected from 2750 primary school students aged between 11-14 years in Istanbul. RESULTS The overall prevalence of UI was 8.6% and decreased with age. Prevalence of the diurnal enuresis in children was 67.9% and all of them had non-monosymptomatic enuresis. 83.3% of the children were identifiedwith secondary enuresis for 1-3 years. UI was significantly more common in ...
Journal of School Health, 2005
Irregular bladder and bowel habits can contribute to urinary and bowel problems. Schoolchildren undergoing treatment for these problems often do not follow the recommendation of regular toilet visits at school, claiming negative perceptions of school toilets. This study examined 6- to 16-year-old schoolchildren&amp;#39;s perceptions of school toilets and whether the perceptions affect bladder and bowel habits at school Some 385 Swedish schoolchildren aged 6 to 16 years were surveyed using a semistructured questionnaire. Children aged 13 to 16 years had the most negative perceptions. Twenty-five percent (overall 16%) of older children reported never using the school toilet to urinate, and 80% (overall 63%) never used it to defecate. Perceptions of sight and smell and emotional constraints hindered children from using the school toilets. Children generally based their perceptions of school toilets on physical appearance, offensive smell, and feelings of insecurity. Children&amp;#39;s perceptions affected their toilet habits and would rather endure physical discomfort than the psychological and social discomfort of using the school toilet. Children already suffering from urinary tract or intestinal problems face particular difficulties without regular toilet visits during the day.
Korean Journal of Urology, 2014
Purpose: Urinary incontinence is one of the major urinary symptoms in children and adolescents and can lead to major distress for the affected children and their parents. In accordance with the definitions of the Standardization Committee of the International Children's Continence Society, daytime urinary incontinence (DUI) is uncontrollable leakage of urine during the day. The aim of this cross-sectional study was to investigate the prevalence and associated risk factors of DUI in Turkish primary school children. Materials and Methods: The questionnaire, which covered sociodemographic variables and the voiding habits of the children, was completed by the parents of 2,353 children who were attending primary school in Denizli, a developing city of Turkey. The children's voiding habits were evaluated by use of the Dysfunctional Voiding and Incontinence Symptoms Score, which is a validated questionnaire. Children with a history of neurological or urological diseases were excluded. Results: The participation rate was 91.9% (2,164 people). The overall prevalence of DUI was 8.0%. The incidence of DUI tended to decrease with increasing age and was not significantly different between genders (boys, 8.8%; girls, 7.3%; p=0.062). Age, maternal education level, family history of daytime wetting, settlement (urban/rural), history of constipation, urinary tract infection, and urgency were independent risk factors of DUI. Conclusions: Our findings showed that DUI is a common health problem in primary school children. In an effort to increase awareness of children's voiding problems and the risk factors for urinary dysfunction in the population, educational programs and larger school-based screening should be carried out, especially in regions with low socioeconomic status.
Scholars Journal of Applied Medical Sciences
Main objective of the study was to identify lower urinary tract dysfunction (LUTD) symptoms in children aged 6-12 years by using Modified Dysfunctional Voiding Scoring System (DVSS) and the association of these symptoms with age, sex and other socio-demographic factors. It was an observational study done in 380 normal healthy children between 6-12 years of age attending pediatric OPDs of SMS Medical College jaipur in a period of one year. MODIFIED DVSS was applied in these children and their parents were interviewed. Cut off point considered as indicator of LUTD was >6 for girls and >9 for boys. Different proportions were compared with Chi-square test and Odds ratio. 92 children out of 380, had LUTD score >6 for females and >9 for males. Prevalence of LUTD was 24.2%. LUTD symptoms were more common in 6-9 years of age than the 9-12 yrs age group and the difference was significant statistically (p=0.000) (OR= 2.678, 95%CI= 1.611-4.451) .LUTD symptoms were more common in females (p= 0.018).Female sex was a risk factor for LUTD (OR= 1.662, 95% CI= 1.025-2.694). LUTD symptoms were not affected significantly by type of school, availability of separate toilet facilities in school and residential area of children (p> 0.05) Diurnal urinary incontinence, holding maneuvers, urinary urgency, voiding pain and straining were more commonly present with score 3(high symptom severity) whereas constipation and decreased urinary frequency were more commonly present with score 2 (low symptom severity). The prevalence of LUTD symptom was quite high (24.2%) in school age children. Prevalence of LUTD symptoms was high among children from lower age group and in females. LUTD symptoms must be investigated carefully at routine pediatric visits.