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Lower Urinary Tract Symptoms and Incontinence in Children with Pompe Disease

  • Divya Ajay
  • Erin R. McNamara
  • Stephanie Austin
  • John S. Wiener
  • Priya KishnaniEmail author
Research Report
Part of the JIMD Reports book series (JIMD, volume 28)

Abstract

Background: Pompe disease (PD) is a disorder of lysosomal glycogen storage. The introduction of enzyme replacement therapy (ERT) has shifted the focus of care from survival to quality of life. The presence of lower urinary tract symptoms (LUTS) and incontinence has not been previously described in children with PD.

Methods: Children with PD followed in the Duke Lysosomal Storage Disease Clinic completed a validated bladder control symptom score (BCSS) and additional questions regarding urinary tract infections (UTIs), giggle, and stress incontinence. Descriptive statistics were used to discriminate urinary symptoms between gender, age, and different types of PD.

Results: Sixteen of 23 children (aged 4–14 years) seen in our clinic participated. Seven were girls; ten had classic infantile PD, two atypical infantile PD, and four childhood presentation late-onset PD (LOPD). When stratified by PD subtype, median BCSS was worst for the classic PD subtype followed by atypical PD and LOPD. Daytime urinary incontinence accompanied by constipation was noted in six. Eight reported urinary incontinence with laughing: giggle incontinence in six and stress incontinence in two. Four girls reported a history of UTI. Longitudinal follow-up in 11 patients showed stable BCSS in six, improvement in three, and worsening in two. Worsening corresponded with changes in bowel function and improvement with increase in ERT dose or treatment of constipation.

Conclusions: LUTS and incontinence are common in children with PD with greater symptoms noted with infantile-type PD. Improved bowel function and increase in ERT dose may lead to improvements in BCSS.

Keywords

Incontinence Infantile-type Pompe disease Lower urinary tract symptoms Urinary tract infections 

Abbreviations

BCSS

Bladder control symptom score

ERT

Enzyme replacement therapy

LOPD

Late-onset Pompe disease

LUTS

Lower urinary tract symptoms

PD

Pompe disease

UTIs

Urinary tract infections

Supplementary material

References

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Copyright information

© SSIEM and Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Divya Ajay
    • 1
  • Erin R. McNamara
    • 2
  • Stephanie Austin
    • 3
  • John S. Wiener
    • 1
  • Priya Kishnani
    • 3
    Email author
  1. 1.Division of Urologic Surgery, Department of SurgeryDuke University Medical CenterDurhamUSA
  2. 2.Department of UrologyBoston Children’s HospitalBostonUSA
  3. 3.Division of Medical Genetics, Department of PediatricsDuke University Medical CenterDurhamUSA

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