title: Scintigraphy evaluation of the types of functional constipation in children with bowel bladder dysfunction.
abstract: OBJECTIVE
  To evaluate the types of constipation according to colonic transit time in chronically constipated children with dysfunctional voiding (bowel bladder dysfunction, BBD group) and to compare the results with transit type in children with chronic functional constipation without urinary symptoms (constipation group) and children with normal bowel habits, but with lower urinary tract symptoms (control group).
  
  
  METHODS
  One-hundred and one children were included and their medical histories were obtained. The BBD group kept a voiding diary, and underwent urinalyses and urine culture, ultrasound examination of bladder and kidneys and uroflowmetry with pelvic floor electromyography. Radionuclear transit scintigraphy was performed in all children according to a standardized protocol. Patients were categorized as having either slow-transit (ST), functional fecal retention (FFR) or normal transit.
  
  
  RESULTS
  FFR was diagnosed in 31 out of 38 children with BBD, and 34 out of 43 children in the constipation group. ST was found in seven children with BBD, compared with nine children in the constipation group. The control group children demonstrated normal colonic transit. Urgency, daily urinary incontinence and nocturnal enuresis were noted only in children with FFR. Both children with ST constipation and FFR complained of difficulties during voiding, voiding postponement and urinary tract infections.
  
  
  CONCLUSIONS
  FFR is the most common form of constipation in children with dysfunctional voiding. However, some children might suffer from ST constipation. Differentiation between these two types of constipation is clinically significant because they require different treatment. Future studies with larger numbers of patients are needed to confirm the noted differences in urological symptoms in these two groups of constipated children..
authors.affiliation: Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Centre Nis, Bul. Zorana Djindjica 48, 18 000 Nis, Serbia. Electronic address: petvesna67@gmail.com.
authors.forename: Vesna D
authors.initials: VD
authors.lastname: Zivkovic
authors.affiliation: Institute for Rehabilitation, Sokobanjska 17, 11000 Belgrade, Serbia.
authors.forename: Milica
authors.initials: M
authors.lastname: Lazovic
authors.affiliation: Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Centre Nis, Bul. Zorana Djindjica 48, 18 000 Nis, Serbia.
authors.forename: Ivona
authors.initials: I
authors.lastname: Stankovic
authors.affiliation: Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Centre Nis, Bul. Zorana Djindjica 48, 18 000 Nis, Serbia.
authors.forename: Lidija
authors.initials: L
authors.lastname: Dimitrijevic
authors.affiliation: Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Centre Nis, Bul. Zorana Djindjica 48, 18 000 Nis, Serbia.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Kocic
authors.affiliation: Department of Nuclear Medicine, Clinical Centre Nis, Bul. Zorana Djindjica 48, 18 000 Nis, Serbia.
authors.forename: Marina
authors.initials: M
authors.lastname: Vlajkovic
authors.affiliation: Department of Nuclear Medicine, Clinical Centre Nis, Bul. Zorana Djindjica 48, 18 000 Nis, Serbia.
authors.forename: Milos
authors.initials: M
authors.lastname: Stevic
authors.affiliation: Clinic of Paediatric Surgery, Clinical Centre Nis, Bul. Zorana Djindjica 48, 18 000 Nis, Serbia.
authors.forename: Andjelka
authors.initials: A
authors.lastname: Slavkovic
authors.affiliation: Clinic of Paediatric Surgery, Clinical Centre Nis, Bul. Zorana Djindjica 48, 18 000 Nis, Serbia.
authors.forename: Ivona
authors.initials: I
authors.lastname: Djordjevic
authors.affiliation: Institute for Rehabilitation, Sokobanjska 17, 11000 Belgrade, Serbia.
authors.forename: Marija
authors.initials: M
authors.lastname: Hrkovic
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003248:Constipation / Q000000981:diagnostic imaging*; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000000981:diagnostic imaging*; D008297:Male; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012002:Rectal Diseases / Q000000981:diagnostic imaging*; D053201:Urinary Bladder, Overactive / Q000000981:diagnostic imaging; D014555:Urination Disorders / Q000000981:diagnostic imaging*
keywords: Bowel bladder dysfunction; Colonic scintigraphy; Constipation; Dysfunctional elimination syndrome; Dysfunctional voiding; Slow-transit constipation