WOFAPS 2025 8th World Congress of Pediatric Surgery

Gökçe Karlı ¹, İlayda Ser ², Meltem Kaba ², Mesut Demir ², Tuğba Alpcenan Kurt ², Nihat Sever ²

¹ Health Sciences University, Şişli Hamidiye Etfal SUAM, Pediatric Urology Departmant, Istanbul
² Health Sciences University, Şişli Hamidiye Etfal SUAM, Pediatric Surgery Departmant, Istanbul

Objective: Lower urinary tract dysfunction (LUTD) is a common clinical picture in childhood and accounts for approximately 40% of all admissions to pediatric urology outpatient clinics. Negative effects on mental health and social functioning in adulthood have been reported in untreated cases. In this study, we aimed to compare the epidemiologic characteristics and Voiding Disorder Symptom Scores (VDSS) of pediatric patients diagnosed with AUSD.

Materials and Methods: The data of 120 children referred to our pediatric urology outpatient clinic with a prediagnosis of AUSD between June 2024 and May 2025 were retrospectively analyzed. All patients were given the IBSS form and were asked to complete it in the presence of their parents. Thirty-eight patients who were not diagnosed with AUSD were excluded from the study. Of the 81 patients included in the study, 39 were girls and 42 were boys; their ages ranged between 1 and 18 years.

Results: Of the patients, 55% (n=45) were diagnosed as non-neurogenic and 45% (n=36) as neurogenic bladder dysfunction.

The mean IBSS score was 12.8 in the neurogenic group and 14.3 in the incontinent subgroup. The mean score was 16.3 in 12 patients who underwent clean intermittent catheterization (CIC). 31 patients underwent urodynamics; the score was 18.5 in 6 patients with high bladder pressure. In 7 patients with renal scar on DMSA, the mean score was 15.5.

The mean IBSS score in the non-neurogenic group was 14.4. Daytime incontinence was found in 18, monosymptomatic enuresis nocturna in 18 and non-monosymptomatic enuresis nocturna in 9 patients. Giggle incontinence was diagnosed in 1 patient with AUSD, overactive bladder in 7 patients, underactive bladder in 7 patients and dysfunctional voiding in 4 patients. Bladder-bowel dysfunction was associated in a total of 15 patients.

Urotherapy, medical therapy and biofeedback were applied in the treatment steps. IBSS scores before and after treatment were compared. The mean improvement in IBSS scores was 70%.

Conclusion: AUSD may cause significant negative effects on quality of life, school achievement and self-perception in children. It is possible to significantly improve quality of life even with detailed evaluation of patients and simple urotherapy support in outpatient clinic conditions.