Role of body mass index in school-aged children with lower urinary tract dysfunction: Does weight classification predict treatment outcome?
Summary Introduction Lower urinary tract (LUT) dysfunction comprises a large percentage of pediatric urology referrals. Childhood obesity is a major health concern, and has been associated with voiding symptoms. We assessed the impact of body mass index (BMI) on treatment outcomes of children presen...
Gespeichert in:
| Veröffentlicht in: | Journal of pediatric urology 2017-10, Vol.13 (5), p.454.e1-454.e5 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 454.e5 |
|---|---|
| container_issue | 5 |
| container_start_page | 454.e1 |
| container_title | Journal of pediatric urology |
| container_volume | 13 |
| creator | Arlen, Angela M Cooper, Christopher S Leong, Traci |
| description | Summary Introduction Lower urinary tract (LUT) dysfunction comprises a large percentage of pediatric urology referrals. Childhood obesity is a major health concern, and has been associated with voiding symptoms. We assessed the impact of body mass index (BMI) on treatment outcomes of children presenting with LUT or bladder–bowel dysfunction (BBD). Study design Children aged 5–17 years diagnosed with non-neurogenic LUT dysfunction and no prior urologic diagnoses were identified. Patient demographics including BMI, lower urinary tract symptoms, constipation, medical and psychologic comorbidities, imaging, and treatment outcomes were evaluated. BMI was normalized by age and gender according to percentiles: underweight |
| doi_str_mv | 10.1016/j.jpurol.2017.03.033 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1896894627</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S1477513117301778</els_id><sourcerecordid>1896894627</sourcerecordid><originalsourceid>FETCH-LOGICAL-c417t-37e0ea0231c578e0b1ae9ff5d9563d7b11502d144752ead8cf4e9a4ab28172d13</originalsourceid><addsrcrecordid>eNqFUk1v1DAQjRCIfsA_QMhHLlns2IkdDiBUKEWqVImPs-XYk66DYy-202V_A38aR1s4cKk0skeaN280701VvSB4QzDpXk-babfE4DYNJnyDaQn6qDolgtOaiV48LjnjvG4JJSfVWUoTxpTjpn9anTSCCcq67rT6_SU4QGFEQzAHNKuUkPUGfpUXJb0NwdXqFgzSW-tMBI_2Nm-RC3uIaInWq3hAOSqdkTmkcfE62-DfoA8BEtqDvd1mpF1htaPVaq2hXQRjCz5HUHkGn1FYsg4zvHtWPRmVS_D8_j-vvl9-_HZxVV_ffPp88f661ozwXFMOGBRuKNEtF4AHoqAfx9b0bUcNHwhpcWMIY7xtQBmhRwa9YmpoBOGlQM-rV0feXQw_F0hZzjZpcE55CEuSRPSd6FnX8AJlR6iOIaUIo9xFO5elJcFytUFO8miDXG2QmJagpe3l_YRlmMH8a_qrewG8PQKg7HlnIcqkLXhdpImgszTBPjThfwLtrC8aux9wgDSFJfqioSQyNRLLr-sprJdAOC0sXNA_QNey-A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1896894627</pqid></control><display><type>article</type><title>Role of body mass index in school-aged children with lower urinary tract dysfunction: Does weight classification predict treatment outcome?</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Arlen, Angela M ; Cooper, Christopher S ; Leong, Traci</creator><creatorcontrib>Arlen, Angela M ; Cooper, Christopher S ; Leong, Traci</creatorcontrib><description>Summary Introduction Lower urinary tract (LUT) dysfunction comprises a large percentage of pediatric urology referrals. Childhood obesity is a major health concern, and has been associated with voiding symptoms. We assessed the impact of body mass index (BMI) on treatment outcomes of children presenting with LUT or bladder–bowel dysfunction (BBD). Study design Children aged 5–17 years diagnosed with non-neurogenic LUT dysfunction and no prior urologic diagnoses were identified. Patient demographics including BMI, lower urinary tract symptoms, constipation, medical and psychologic comorbidities, imaging, and treatment outcomes were evaluated. BMI was normalized by age and gender according to percentiles: underweight < 5th, healthy 5th to <85th, overweight 85th to <95th, and obese > 95th percentile. Uni- and multivariate analyses were performed to identify predictors of treatment response. Results During an 18-month period, 100 children (54 girls, 46 boys) met the inclusion criteria. The mean age at diagnosis was 7.7 ± 2.4 years, and mean length of follow-up 15.3 ± 13.1 months. Sixty-nine patients were a normal weight, 22 were overweight, and nine were obese. Fifteen percent of the children had complete treatment response, 63% partial response, and 22% non-response. On univariate analysis, children with elevated BMI ( p = 0.04) or history of urinary tract infection ( p = 0.01) were statistically more likely to not respond to treatment. Controlling for all other variables, children with BMI > 85th percentile had 3.1 times (95% CI 1.11–8.64; p = 0.03) increased odds of treatment failure (Table). Discussion BBD management includes implementation of a bowel program and timed voiding regimen, with additional treatment modalities tailored on the basis of the prevailing symptoms. We observed that school-aged children with a BMI ≥ 85th percentile were over three times more likely to experience treatment failure when controlling for all other patient characteristics including constipation and a history of urinary tract infection. Limitations of the study include the relatively small sample size, lack of uroflow with electromyography to confirm the presence or the absence of detrusor sphincter dyssynergia, and inconsistent anticholinergic dosing. Conclusions Nearly one-third of school-aged children presenting to our institution with LUT or BBD were overweight or obese when normalized for age and gender. Children with LUT dysfunction and elevated BMI are significantly less likely to experience treatment response. Table Multivariate analysis. Relationship between specific patient characteristics and treatment outcome using logistic regression. Table Variable Beta (SE) OR 95% CI for OR p Intercept −4.53 (1.57) – – 0.004 Sex 0.52 (0.54) 1.68 0.58–4.85 0.33 Age (years) 0.05 (0.11) 1.05 0.85–1.29 0.66 BMI 1.13 (0.52) 3.09 1.11–8.64 0.03 UTI 1.33 (0.52) 3.78 1.35–10.56 0.01 Medical comorbidities −0.90 (0.63) 0.41 0.12–1.39 0.15 Psych comorbidities 0.43 (0.56) 1.53 0.51–4.56 0.45 BMI = body mass index; UTI = urinary tract infection.</description><identifier>ISSN: 1477-5131</identifier><identifier>EISSN: 1873-4898</identifier><identifier>DOI: 10.1016/j.jpurol.2017.03.033</identifier><identifier>PMID: 28483466</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Bladder–bowel dysfunction ; Body Mass Index ; Body Weight ; Child ; Child, Preschool ; Constipation ; Female ; Humans ; Lower urinary tract dysfunction ; Lower Urinary Tract Symptoms - etiology ; Lower Urinary Tract Symptoms - therapy ; Male ; Obesity ; Pediatric Obesity - complications ; Pediatrics ; Risk Factors ; Treatment Outcome ; Urinary tract infection ; Urology</subject><ispartof>Journal of pediatric urology, 2017-10, Vol.13 (5), p.454.e1-454.e5</ispartof><rights>Journal of Pediatric Urology Company</rights><rights>2017 Journal of Pediatric Urology Company</rights><rights>Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-37e0ea0231c578e0b1ae9ff5d9563d7b11502d144752ead8cf4e9a4ab28172d13</citedby><cites>FETCH-LOGICAL-c417t-37e0ea0231c578e0b1ae9ff5d9563d7b11502d144752ead8cf4e9a4ab28172d13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1477513117301778$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28483466$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arlen, Angela M</creatorcontrib><creatorcontrib>Cooper, Christopher S</creatorcontrib><creatorcontrib>Leong, Traci</creatorcontrib><title>Role of body mass index in school-aged children with lower urinary tract dysfunction: Does weight classification predict treatment outcome?</title><title>Journal of pediatric urology</title><addtitle>J Pediatr Urol</addtitle><description>Summary Introduction Lower urinary tract (LUT) dysfunction comprises a large percentage of pediatric urology referrals. Childhood obesity is a major health concern, and has been associated with voiding symptoms. We assessed the impact of body mass index (BMI) on treatment outcomes of children presenting with LUT or bladder–bowel dysfunction (BBD). Study design Children aged 5–17 years diagnosed with non-neurogenic LUT dysfunction and no prior urologic diagnoses were identified. Patient demographics including BMI, lower urinary tract symptoms, constipation, medical and psychologic comorbidities, imaging, and treatment outcomes were evaluated. BMI was normalized by age and gender according to percentiles: underweight < 5th, healthy 5th to <85th, overweight 85th to <95th, and obese > 95th percentile. Uni- and multivariate analyses were performed to identify predictors of treatment response. Results During an 18-month period, 100 children (54 girls, 46 boys) met the inclusion criteria. The mean age at diagnosis was 7.7 ± 2.4 years, and mean length of follow-up 15.3 ± 13.1 months. Sixty-nine patients were a normal weight, 22 were overweight, and nine were obese. Fifteen percent of the children had complete treatment response, 63% partial response, and 22% non-response. On univariate analysis, children with elevated BMI ( p = 0.04) or history of urinary tract infection ( p = 0.01) were statistically more likely to not respond to treatment. Controlling for all other variables, children with BMI > 85th percentile had 3.1 times (95% CI 1.11–8.64; p = 0.03) increased odds of treatment failure (Table). Discussion BBD management includes implementation of a bowel program and timed voiding regimen, with additional treatment modalities tailored on the basis of the prevailing symptoms. We observed that school-aged children with a BMI ≥ 85th percentile were over three times more likely to experience treatment failure when controlling for all other patient characteristics including constipation and a history of urinary tract infection. Limitations of the study include the relatively small sample size, lack of uroflow with electromyography to confirm the presence or the absence of detrusor sphincter dyssynergia, and inconsistent anticholinergic dosing. Conclusions Nearly one-third of school-aged children presenting to our institution with LUT or BBD were overweight or obese when normalized for age and gender. Children with LUT dysfunction and elevated BMI are significantly less likely to experience treatment response. Table Multivariate analysis. Relationship between specific patient characteristics and treatment outcome using logistic regression. Table Variable Beta (SE) OR 95% CI for OR p Intercept −4.53 (1.57) – – 0.004 Sex 0.52 (0.54) 1.68 0.58–4.85 0.33 Age (years) 0.05 (0.11) 1.05 0.85–1.29 0.66 BMI 1.13 (0.52) 3.09 1.11–8.64 0.03 UTI 1.33 (0.52) 3.78 1.35–10.56 0.01 Medical comorbidities −0.90 (0.63) 0.41 0.12–1.39 0.15 Psych comorbidities 0.43 (0.56) 1.53 0.51–4.56 0.45 BMI = body mass index; UTI = urinary tract infection.</description><subject>Adolescent</subject><subject>Bladder–bowel dysfunction</subject><subject>Body Mass Index</subject><subject>Body Weight</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Constipation</subject><subject>Female</subject><subject>Humans</subject><subject>Lower urinary tract dysfunction</subject><subject>Lower Urinary Tract Symptoms - etiology</subject><subject>Lower Urinary Tract Symptoms - therapy</subject><subject>Male</subject><subject>Obesity</subject><subject>Pediatric Obesity - complications</subject><subject>Pediatrics</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Urinary tract infection</subject><subject>Urology</subject><issn>1477-5131</issn><issn>1873-4898</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUk1v1DAQjRCIfsA_QMhHLlns2IkdDiBUKEWqVImPs-XYk66DYy-202V_A38aR1s4cKk0skeaN280701VvSB4QzDpXk-babfE4DYNJnyDaQn6qDolgtOaiV48LjnjvG4JJSfVWUoTxpTjpn9anTSCCcq67rT6_SU4QGFEQzAHNKuUkPUGfpUXJb0NwdXqFgzSW-tMBI_2Nm-RC3uIaInWq3hAOSqdkTmkcfE62-DfoA8BEtqDvd1mpF1htaPVaq2hXQRjCz5HUHkGn1FYsg4zvHtWPRmVS_D8_j-vvl9-_HZxVV_ffPp88f661ozwXFMOGBRuKNEtF4AHoqAfx9b0bUcNHwhpcWMIY7xtQBmhRwa9YmpoBOGlQM-rV0feXQw_F0hZzjZpcE55CEuSRPSd6FnX8AJlR6iOIaUIo9xFO5elJcFytUFO8miDXG2QmJagpe3l_YRlmMH8a_qrewG8PQKg7HlnIcqkLXhdpImgszTBPjThfwLtrC8aux9wgDSFJfqioSQyNRLLr-sprJdAOC0sXNA_QNey-A</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Arlen, Angela M</creator><creator>Cooper, Christopher S</creator><creator>Leong, Traci</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20171001</creationdate><title>Role of body mass index in school-aged children with lower urinary tract dysfunction: Does weight classification predict treatment outcome?</title><author>Arlen, Angela M ; Cooper, Christopher S ; Leong, Traci</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-37e0ea0231c578e0b1ae9ff5d9563d7b11502d144752ead8cf4e9a4ab28172d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Bladder–bowel dysfunction</topic><topic>Body Mass Index</topic><topic>Body Weight</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Constipation</topic><topic>Female</topic><topic>Humans</topic><topic>Lower urinary tract dysfunction</topic><topic>Lower Urinary Tract Symptoms - etiology</topic><topic>Lower Urinary Tract Symptoms - therapy</topic><topic>Male</topic><topic>Obesity</topic><topic>Pediatric Obesity - complications</topic><topic>Pediatrics</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><topic>Urinary tract infection</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arlen, Angela M</creatorcontrib><creatorcontrib>Cooper, Christopher S</creatorcontrib><creatorcontrib>Leong, Traci</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arlen, Angela M</au><au>Cooper, Christopher S</au><au>Leong, Traci</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of body mass index in school-aged children with lower urinary tract dysfunction: Does weight classification predict treatment outcome?</atitle><jtitle>Journal of pediatric urology</jtitle><addtitle>J Pediatr Urol</addtitle><date>2017-10-01</date><risdate>2017</risdate><volume>13</volume><issue>5</issue><spage>454.e1</spage><epage>454.e5</epage><pages>454.e1-454.e5</pages><issn>1477-5131</issn><eissn>1873-4898</eissn><abstract>Summary Introduction Lower urinary tract (LUT) dysfunction comprises a large percentage of pediatric urology referrals. Childhood obesity is a major health concern, and has been associated with voiding symptoms. We assessed the impact of body mass index (BMI) on treatment outcomes of children presenting with LUT or bladder–bowel dysfunction (BBD). Study design Children aged 5–17 years diagnosed with non-neurogenic LUT dysfunction and no prior urologic diagnoses were identified. Patient demographics including BMI, lower urinary tract symptoms, constipation, medical and psychologic comorbidities, imaging, and treatment outcomes were evaluated. BMI was normalized by age and gender according to percentiles: underweight < 5th, healthy 5th to <85th, overweight 85th to <95th, and obese > 95th percentile. Uni- and multivariate analyses were performed to identify predictors of treatment response. Results During an 18-month period, 100 children (54 girls, 46 boys) met the inclusion criteria. The mean age at diagnosis was 7.7 ± 2.4 years, and mean length of follow-up 15.3 ± 13.1 months. Sixty-nine patients were a normal weight, 22 were overweight, and nine were obese. Fifteen percent of the children had complete treatment response, 63% partial response, and 22% non-response. On univariate analysis, children with elevated BMI ( p = 0.04) or history of urinary tract infection ( p = 0.01) were statistically more likely to not respond to treatment. Controlling for all other variables, children with BMI > 85th percentile had 3.1 times (95% CI 1.11–8.64; p = 0.03) increased odds of treatment failure (Table). Discussion BBD management includes implementation of a bowel program and timed voiding regimen, with additional treatment modalities tailored on the basis of the prevailing symptoms. We observed that school-aged children with a BMI ≥ 85th percentile were over three times more likely to experience treatment failure when controlling for all other patient characteristics including constipation and a history of urinary tract infection. Limitations of the study include the relatively small sample size, lack of uroflow with electromyography to confirm the presence or the absence of detrusor sphincter dyssynergia, and inconsistent anticholinergic dosing. Conclusions Nearly one-third of school-aged children presenting to our institution with LUT or BBD were overweight or obese when normalized for age and gender. Children with LUT dysfunction and elevated BMI are significantly less likely to experience treatment response. Table Multivariate analysis. Relationship between specific patient characteristics and treatment outcome using logistic regression. Table Variable Beta (SE) OR 95% CI for OR p Intercept −4.53 (1.57) – – 0.004 Sex 0.52 (0.54) 1.68 0.58–4.85 0.33 Age (years) 0.05 (0.11) 1.05 0.85–1.29 0.66 BMI 1.13 (0.52) 3.09 1.11–8.64 0.03 UTI 1.33 (0.52) 3.78 1.35–10.56 0.01 Medical comorbidities −0.90 (0.63) 0.41 0.12–1.39 0.15 Psych comorbidities 0.43 (0.56) 1.53 0.51–4.56 0.45 BMI = body mass index; UTI = urinary tract infection.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>28483466</pmid><doi>10.1016/j.jpurol.2017.03.033</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1477-5131 |
| ispartof | Journal of pediatric urology, 2017-10, Vol.13 (5), p.454.e1-454.e5 |
| issn | 1477-5131 1873-4898 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1896894627 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adolescent Bladder–bowel dysfunction Body Mass Index Body Weight Child Child, Preschool Constipation Female Humans Lower urinary tract dysfunction Lower Urinary Tract Symptoms - etiology Lower Urinary Tract Symptoms - therapy Male Obesity Pediatric Obesity - complications Pediatrics Risk Factors Treatment Outcome Urinary tract infection Urology |
| title | Role of body mass index in school-aged children with lower urinary tract dysfunction: Does weight classification predict treatment outcome? |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T19%3A11%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Role%20of%20body%20mass%20index%20in%20school-aged%20children%20with%20lower%20urinary%20tract%20dysfunction:%20Does%20weight%20classification%20predict%20treatment%20outcome?&rft.jtitle=Journal%20of%20pediatric%20urology&rft.au=Arlen,%20Angela%20M&rft.date=2017-10-01&rft.volume=13&rft.issue=5&rft.spage=454.e1&rft.epage=454.e5&rft.pages=454.e1-454.e5&rft.issn=1477-5131&rft.eissn=1873-4898&rft_id=info:doi/10.1016/j.jpurol.2017.03.033&rft_dat=%3Cproquest_cross%3E1896894627%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1896894627&rft_id=info:pmid/28483466&rft_els_id=1_s2_0_S1477513117301778&rfr_iscdi=true |