Datasheet1_Prevalence, risk factors, psychological effects of children and adolescents with lower urinary tract symptoms: a large population-based study.pdf

BackgroundLower urinary tract symptoms (LUTS) are clinically frequent and seriously affect the psychological and mental health of children and adolescents. However, most studies on LUTS and its influence on the psychological behavior and mental health have focused on adults. This study aimed to investigate LUTS prevalence and associated factors in children and adolescents and explore its impact on psychological behavior.
Materials and methodsFrom October 2019 to November 2021, an epidemiological LUTS survey was carried out on 6,077 children aged 6–15 years old in 12 primary and secondary schools in China by using anonymous questionnaires.
ResultsA total of 5,500 valid questionnaires were collected, and the total prevalence of four representative symptoms of LUTS: urgency, frequency, daytime urinary incontinence, and nocturnal enuresis was 19.46%, 14.55%, 9.75%, and 8.4%, respectively. The prevalence decreased with age, which decreased rapidly in children aged 6–12 years old. The incidence of LUTS in those who did not continue to use disposable diapers (DD) and began to perform elimination communication (EC) after the age of 1 was significantly higher than that of those who stopped using DD and started EC before 1 year of age (P < 0.05). There were significant differences in the occurrence of LUTS without toiled training (TT) (P < 0.05). The prevalence of LUTS in males was significantly higher than in females (P < 0.05). LUTS in children and adolescents with constipation was significantly higher compared to those without constipation (P < 0.05). The detection rate of abnormal psychological behavior in the LUTS group was 44.6%, which was significantly higher than that in the no LUTS group (21.4%, P < 0.05). The scores of emotional symptoms, conduct problems, hyperactivity, and peer communication problems were significantly higher in the LUTS group than the control group.
ConclusionsIn Mainland China, the prevalence of LUTS in children and adolescents is high. Continued use of DD after 1 year of age, history of urinary tract infection, lack of TT, and constipation were risk factors for LUTS. EC before 1 year of age is a protective factor for LUTS. The prevalence of psychological behavioral abnormalities is high in children and adolescents with LUTS, which needs to be more concerned.

下尿路症状（Lower urinary tract symptoms, LUTS）在临床中十分常见，严重影响儿童与青少年的心理精神健康。然而，目前针对LUTS及其对心理行为与精神健康影响的研究大多聚焦于成人群体。本研究旨在调查儿童青少年群体中LUTS的患病率及相关影响因素，并探讨其对心理行为的影响。
材料与方法 2019年10月至2021年11月，本研究采用匿名问卷方式，对中国12所中小学的6077名6~15岁儿童青少年开展LUTS流行病学调查。
结果 本研究共回收有效问卷5500份。LUTS四类代表性症状——尿急、尿频、日间尿失禁与夜间遗尿的总患病率分别为19.46%、14.55%、9.75%与8.4%。患病率随年龄增长呈下降趋势，在6至12岁儿童群体中下降尤为迅速。1岁后仍持续使用一次性尿布（disposable diapers, DD）且未开展排尿沟通（elimination communication, EC）的人群，其LUTS患病率显著高于1岁前停用DD并启动EC的群体（P < 0.05）。未接受如厕训练（toiled training, TT）的儿童LUTS发生率存在显著组间差异（P < 0.05）。男性群体LUTS患病率显著高于女性（P < 0.05）。合并便秘的儿童青少年LUTS患病率显著高于无便秘群体（P < 0.05）。LUTS组儿童青少年的心理行为异常检出率为44.6%，显著高于非LUTS组的21.4%（P < 0.05）。LUTS组在情绪症状、品行问题、多动症状及同伴交往问题的得分均显著高于对照组。
结论 在中国内地，儿童青少年LUTS患病率较高。1岁后持续使用DD、尿路感染病史、缺乏如厕训练以及便秘均为LUTS的危险因素；1岁前开展EC则为LUTS的保护因素。合并LUTS的儿童青少年心理行为异常患病率较高，该问题亟需得到更多关注。