OBJECTIVE: To determine the congruence between self-reported and objective data on incontinence, voided volume (VV) and voiding frequency (VF), in a prospective study of treatment of functional urinary incontinence (UI) due to urge syndrome or dysfunctional voiding in children. PATIENTS AND METHODS: In all, 202 children, enrolled in the European Bladder Dysfunction Study (EBDS), provided self-reported data on UI, VV and VF, before and after treatment, with validated questionnaires and 72-h voiding diaries. Objective data were obtained with uroflowmetry and a 12-h pad test, also before and after treatment. Questionnaires and diaries were checked and scored by a urotherapist, at scheduled office visits that were combined with uroflowmetry. RESULTS: At entry, parents under-reported UI on the questionnaires in 45% of cases, compared with the urotherapist's scores, and the 12-h pad test sensitivity for UI was only 64% (95% confidence interval 55-73%). The voiding diaries had inconsistent entries on UI and on VV. VF was overestimated in the questionnaires and underestimated in the diaries, compared with the urotherapist's scores. A VF of >7/day decreased significantly after EBDS treatment, but with no correlation with treatment outcome. The mean VV increased significantly after treatment for UI, also with no correlation with treatment outcome. CONCLUSIONS: Voiding diaries and questionnaires are useful tools for charting individual treatment and for screening, but they are ill-suited to documenting outcome variables in urge syndrome or dysfunctional voiding, because of over- and under-reporting. VV and VF lack specificity as outcome variables in children with urge syndrome or dysfunctional voiding. The 12-h pad test is not sensitive enough to complement self-reported symptoms of UI in children with urge syndrome or dysfunctional voiding. Clinical studies on UI rely on complaints and self-reported symptoms, but in children the reporting should be supervised by a trained urotherapist, to provide the necessary checks and balances.

Dysfunctional voiding, Non-neuropathic bladder-sphincter dysfunction, Pad test, Urge syndrome, Urinary incontinence, Voiding diary
dx.doi.org/10.1111/j.1464-410X.2007.06933.x, hdl.handle.net/1765/36881
BJU International
Erasmus MC: University Medical Center Rotterdam

Bael, A, Lax, H, Hirche, H, Gäbel, E, Winkler, P, Hellström, A.-L, … van Gool, J.D. (2007). Self-reported urinary incontinence, voiding frequency, voided volume and pad-test results: Variables in a prospective study in children. BJU International, 100(3), 651–656. doi:10.1111/j.1464-410X.2007.06933.x