Dysfunctional elimination syndrome: is it related to urinary tract infection or vesicoureteral reflux diagnosed early in life?
OBJECTIVE
It has been suggested that urinary tract infections (UTIs) early in life predispose to dysfunctional elimination syndrome (DES). This study evaluated the relationship between early UTI, vesicoureteral reflux (VUR), and DES by comparing two cohorts of school-aged children.


METHODS
The UTI cohort (n = 123) included children previously enrolled in a prospective treatment trial conducted between 1992 and 1997. All were diagnosed with a febrile UTI before 2 years of age. The comparison cohort (n = 125) included children who were evaluated for fever in the emergency department between 1992 and 1997, whose urine culture was negative. Dysfunctional elimination symptoms were compared in the two cohorts by having families complete a revised version of the Dysfunctional Voiding Scoring System.


RESULTS
Completed questionnaires were received from 248 children. There were no significant differences in selected demographic or clinical characteristics between the two cohorts. DES was present in 22% and 21% of children with and without a history of early UTI, respectively. Among children with UTIs, 18% of those with VUR and 25% of those without VUR had DES.


CONCLUSIONS
Dysfunctional elimination is common in a general pediatric population. Neither UTI nor VUR diagnosed before 2 years of age was associated with DES in school-aged children.
Department of Pediatrics, University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania 15213-2583, USA. nader.shaikh@chp.edu
Nader
N
Shaikh
Alejandro
A
Hoberman
Barbara
B
Wise
Marcia
M
Kurs-Lasky
Diana
D
Kearney
Stephanie
S
Naylor
Mary Ann
MA
Haralam
D K
DK
Colborn
Steven G
SG
Docimo
D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D019960:Elimination Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012494:Sampling Studies; D011795:Surveys and Questionnaires; D014552:Urinary Tract Infections / Q000150:complications*; D014718:Vesico-Ureteral Reflux / Q000150:complications*; D035862:Vulnerable Populations