Korean J Urol.  2011 Mar;52(3):210-215.

Correlation between Lower Urinary Tract Scoring System, Behavior Check List, and Bladder Sonography in Children with Lower Urinary Tract Symptoms

• Hooman N
• Hallaji F
• Mostafavi
• Mohsenifar S
• Otukesh H
• Moradi-Lakeh M

Abstract

PURPOSE
The Pediatric Lower Urinary Tract Scoring System (PLUTSS) is a standardized questionnaire used for screening and evaluation of the response of children with lower urinary tract symptoms (LUTS) to therapy. We presumed that adding the Child Behavior Check List (CBCL) and bladder volume wall index (BVWI) to the PLUTSS would increase its validity in the detection of children with LUTS.
MATERIALS AND METHODS
One hundred twenty-two children aged 5 to 15 years with LUTS were enrolled in the study. Seventy-two healthy, age-matched children without urinary complaints were considered as controls. The PLUTSS and CBCL were filled out for all children. Sonography was performed to measure BVWI. Chi-square test and likelihood ratio were used to compare frequencies, receiver operating curve (ROC) analysis was used to evaluate the correlation, and Cohen's kappa was used to measure the agreement between variables. p-values <0.05 were considered significant.
RESULTS
Behavior problems were significantly more common in children with LUTS than in healthy children (p<0.05). The frequency of thick, thin, and normal BVWIs did not differ significantly in the two groups (p>0.05). ROC analysis showed that there was no correlation between PLUTSS, CBCL, and BVWI in either the LUTS subgroup or in the controls (p>0.05). The PLUTSS had the highest sensitivity and specificity, and adding the two other tests decreased its validity for the diagnosis of children with LUTS.
CONCLUSIONS
The PLUTSS by itself was the best predictor of LUTS. The CBCL and BVWI were not helpful in making a diagnosis; however, the CBCL was useful in the detection of behavior problems in children with non-monosymptomatic enuresis.

Keyword

Enuresis; Pediatrics; Questionnaires; Ultrasonography; Urinary bladder

MeSH Terms

Aged
Child
Child Behavior
Enuresis
Humans
Lower Urinary Tract Symptoms
Mass Screening
Pediatrics
ROC Curve
Sensitivity and Specificity
Urinary Bladder
Urinary Tract

Figure

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  FIG. 1 The number of filled-out questionnaires and measurements of BVWI for children who were enrolled in the study. LUTS: lower urinary tract symptoms, BVWI: bladder volume wall index.

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  FIG. 2 Receiver operating curve (ROC) curve for the pediatric lower urinary tract scoring system (PLUTSS), Child Behavior Check List (CBCL), and bladder volume wall index (BVWI) for children with lower urinary tract symptoms compared with controls. The table shows area under the curve.

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