title: Prevalence of lower urinary tract symptoms in individuals with Down syndrome.
abstract: OBJECTIVE
  Down syndrome (DS), which is caused by the trisomy of chromosome 21, is the most frequent of all genetic syndromes. The current study aims to estimate the prevalence of lower urinary tract symptoms (LUTS) in individuals with DS buy using the Dysfunctional Voiding Symptom Score (DVSS) and correlate with functional constipation, age, and gender, as well as determine the most sensitive and specific factors associated with LUTS.
  
  
  METHODS
  LUTS was assessed in individuals with DS using a cross-sectional study through the application of a validated and adapted version of the DVSS for the Brazilian population. The presence of functional constipation was evaluated according to the Rome III criteria.
  
  
  RESULTS
  Of the 114 individuals assessed, 84 were included in the study (median age 16 ± 5.0 years, 66.7% female). The prevalence of LUTS was 27.3%. The symptoms were more frequent in males (OR 3.0, 95% CI 1.1-8.3, p = 0.03) and in individuals younger than 10 years of age (OR 5.2, 95% CI 1.8-14, p = 0.001). Functional constipation was observed in 50% of subjects. It was detected in 95.65% of the individuals with LUTS and 32.78% without LUTS (OR 45.1, 95% CI 5.66-301, p = 0.001). The symptom listed in question 8 ("push to pee") was the most specific indicator. When present, this symptom indicated a higher probability of LUTS (LR+ = 6.3), while the symptom listed in question 4 ("push for bowel movements to come out") showed high sensitivity and, when absent, indicated a lower probability of LUTS (LR- = 0.1).
  
  
  CONCLUSIONS
  LUTS was more prevalent in young males with DS and appeared to improve with age. Functional constipation was strongly associated with LUTS. These findings will contribute to raising the awareness of professionals involved in the follow-up of individuals with DS regarding the clinical manifestations and the need for a standardized investigation of LUTS.
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil; School of Medical Sciences and Health, Juiz de Fora, Minas Gerais, Brazil. Electronic address: fonsecamreis@terra.com.br.
authors.forename: Flávia Cristina
authors.initials: FC
authors.lastname: de Carvalho Mrad
authors.affiliation: State University of Feira de Santana, Feira de Santana, Bahia, Brazil.
authors.forename: José
authors.initials: J
authors.lastname: de Bessa
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Adrianne Maria Berno
authors.initials: AM
authors.lastname: de Rezende Duarte
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Augusto Alves Pinho
authors.initials: AA
authors.lastname: Vieira
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Frederico Cantarino Cordeiro
authors.initials: FC
authors.lastname: Araujo
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Maíra Lorenzo
authors.initials: ML
authors.lastname: de Sá Camargo
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Sandra Helena Cerrato
authors.initials: SH
authors.lastname: Tibiriça
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: André Avarese
authors.initials: AA
authors.lastname: de Figueiredo
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: José Murillo
authors.initials: JM
authors.lastname: de Bastos Netto
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001938:Brazil; D002648:Child; D003248:Constipation / Q000150:complications; D003430:Cross-Sectional Studies; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D015995:Prevalence; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D055815:Young Adult
keywords: Children; Down syndrome; Dysfunctional voiding symptom score; Functional constipation; Prevalence; Voiding disorder