Abstract
Objective
This study was organized to form a symptom scale for diagnosis and assessment of urinary and bowel symptoms in children with dysfunctional elimination syndrome (DES).
Methods
The study group included 81 children presented to our clinic with symptoms of DES like enuresis, abnormal voiding, urinary tract infection and urgency, between January 2003 and February 2004. Age matched 102 children with no history of urological complaints were randomly recruited from a public school as control group. Children with isolated, mono-symptomatic nocturnal enuresis were not taken to the study. All children and parents were requested to fill a 35-item questionnaire related to symptoms of DES. After statistical analysis, questions from the initial form that had a P-value <0.05 and an area under curve (AUC) value >0.6 were selected to form a final scale.
Results
The mean ages for study and control groups were 8.7 ± 2.5 and 8.3 ± 2.2 years, respectively (P = 0.236). The final scale was composed of 15 questions. The cut-off score for the presence of DES was determined as 7.5 (sensitivity 85.2%, specificity 93.1%, AUC value = 0.943) for the total population. When only the male population were concerned the cut-off score was 4.5 (sensitivity 93.8%, specificity 78%, AUC value = 0.913) while the cut-off score for the female population was 7.5␣(sensitivity 87.7%, specificity 94.2%, AUC value = 0.953).
Conclusion
Providing objective assessment of symptom severity, formation of a validated scoring system for children with DES might be a good tool for diagnosis, confirmation of treatment results and follow up. It might also be useful for screening purposes.
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Appendices
Appendix A
Questionnaire for Dysfunctional Elimination Syndrome
Date:
Name-surname:
Sex:
Age:
Telephone number:
Address:
Part-1 (Questions for the Child)
Urgency Symptoms (During the last 3–6 months)
These questions will help us to understand the problems related to your complaints. Please think about your toilet habits during the last 3–6 months, and choose the best answer that fits to your habits.
Appendix B
Final symptom scale for children with dysfunctional elimination syndrome
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Tokgöz, H., Tan, M.Ö., Şen, İ. et al. Assessment of urinary symptoms in children with dysfunctional elimination syndrome. Int Urol Nephrol 39, 425–436 (2007). https://doi.org/10.1007/s11255-006-9062-0
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DOI: https://doi.org/10.1007/s11255-006-9062-0