Incidence And Risk Factors Of Lower Urinary Tract Symptoms In Children In Northern Henan And Their Impact On Psychology

BackgroundLower urinary tract symptoms（LUTS）are common in clinical practice and are a symptom with extremely complex causes.Its occurrence involves a variety of factors such as complex neurological,mental and tissue anatomical functions,mainly including urgency,frequency,daytime urinary incontinence（DUI）,nocturnal enuresis（NE）,etc.Urinary symptoms have a large negative impact on the physical and psychological development of children.At present,most of the studies on LUTS are aimed at young children and adults,and there is a lack of research on the incidence and related factors of LUTS in children.Therefore,to investigate the incidence of LUTS and related factors in this age group,and to analyze the influence of LUTS on psychological factors,will help to understand the current situation and related risk factors of LUTS in children,so as to prevent and treat LUTS in children.Provide reference for reducing its psychological impact.ObjectivesTo investigate the incidence and related influencing factors of LUTS in children,and to evaluate the impact of children with LUTS on their psychology and sleep.MethodsFrom December 2019 to June 2020,a stratified random cluster sampling method was used to conduct an epidemiological survey of LUTS among 4,100 students in 5 primary and secondary schools in Yuan-yang County,Henan Province.Inclusion criteria:（1）full-time primary and secondary school students;（2）volunteered to participate in this researcher;（3）not taking drugs for the treatment of urinary system diseases in the past 2 months,and having a physical examination in good health.Exclusion criteria:（1）children with mental or neurological diseases;（2）chronic urinary tract diseases;（3）history of surgery on the urinary system or pelvic organs;（4）inconsistencies in the contents of the questionnaire;（5）missing contents in the questionnaire>20%.Using:（1）General Information Questionnaire;（2）LUTS Questionnaire;（3）Strengths and Difficulties Questionnaire（SDQ）;（4）Children’s Sleep Questionnaire（PSQ）.Epidata 3.1 was used for input,and SPSS 25.0 was used for statistical analysis.Mean±standard deviation,χ~2 test,binary logistic regression,and Pearson correlation analysis were used.Results1.A total of 4100 paper copies of questionnaires were distributed in this survey,and3885 valid questionnaires were returned,with a valid return rate of 94.76%.The number of males and females was 1993 and 1892 respectively,aged 6-16 years,with a mean age of（10.92±3.16）years and a mean height of（143.89±18.88）cm.The results showed that the overall number of children aged 6-16 years with OAB was 409（10.53%）.Of these,264（6.80%）had dry OAB and 145（3.73%）had wet OAB;246（6.33%）had mild OAB,160（4.20%）had moderate OAB and 3（0.08%）had severe OAB.At least one type of LUTS was present in 821（21.13%）,including urinary urgency in 638（16.42%）,urinary frequency in424（10.91%）,DUI in 288（7.41%）and NE in 309（7.95%）;frequency and urgency together in 303（7.80%）and all three symptoms of urinary frequency,urgency and DUI together in108（2.78%）,and 79（2.03%）had all three symptoms of urinary frequency,urgency,DUI and NE.2.The prevalence of LUTS in children who started urine training before 1 year was lower than that in children who started after 1 year（P<0.001）,the occurrence of LUTS was not affected by toilet training before 18 months（P<0.001）,and there was previous RUTI History and constipation were related to the prevalence of LUTS（P<0.05）.The prevalence of LUTS in males was significantly higher than that in females（P<0.05）.There was a significant difference between children with constipation and boys with prepuce and phimosis（P<0.05）.3.LUTS was correlated with the occurrence of emotional symptoms,conduct problems,hyperactivity symptoms,peer interaction problems,total difficulty score and PSQ total score,and the differences were statistically significant（P<0.001）,while urgency,frequency,DUI,there was no significant correlation between NE and OAB groups and prosocial behavior（P>0.05）.ConclusionsThe incidence of LUTS in children was higher（21.13%）and showed a decreasing trend with increasing age.Wet diaper use after 1 year of age,history of recurrent urinary tract infection（RUTI）,lack of toilet training before 18 months,constipation,and abnormal prepuce in boys were risk factors for LUTS.Urine training before 1 year of age is a protective factor for LUTS.Children with LUTS are prone to emotional and behavioral problems and deserve more attention.