title: Are seasonal and income variations accountable for bowel and bladder dysfunction symptoms in children?
abstract: Certain illnesses tend to occur more commonly at certain times of the year. It is also known that individuals of different socioeconomic groups have a predilection for physical ailments that in some cases may be related to poor access to healthcare or may be related to environmental or work related causes. We hypothesized that there may be a difference between patients from season to season and from different socioeconomic groups and their presenting lower urinary tract symptoms (LUTS).
  
  
  
  We reviewed our electronic medical record going back for 5 years, selecting out all patients who presented to all 10 of our offices in a wide geographic area that covers 22 million people of all races and income levels in the Tristate area of New York.
  
  
  
  We identified 13,346 patients, 6,010 males and 6,957 females, and 379 were excluded for not meeting age inclusion criteria. The descriptive statistics based on age, median income for both males and females can be found in Tables I, II, III, and IV, respectively. Of note, males were older than females at presentation (8.1 vs. 6.9 years) with no difference in median incomes between families. There were more UTIs in females and more dysuria complaints in males. Urinary incontinence also appeared to be more prevalent in females than males, while males had more issues with fecal soiling than the females. What was obvious was that urgency and frequency was positively correlated with high income groups. On the other hand urinary incontinence represented either by itself or combined with UUI was more prevalent in the high school group. Fecal soiling was also more prevalent in the high school group. UTIs were more prevalent in the high school group but surprisingly there was no difference in patients that were not able to empty their bladders. Conversely we found that constipation was more prevalent in the professional group than in the other groups which is the opposite of the FS findings. Lastly dysuria appeared to be more prevalent in the P group.
  
  
  
  It is clear that there are marked differences in the results between high school income and professional income groups in particular with the U and F, along with C which correlate with high income professionals' children. UUI, UI, UTI, along with FS are associated with high school income parents. Neurourol. Urodynam. 36:148-154, 2017. © 2015 Wiley Periodicals, Inc.
authors.affiliation: New York Medical College, Valhalla, New York.
authors.forename: Israel
authors.initials: I
authors.lastname: Franco
authors.affiliation: Stony Brook Medical School, Stonybrook, New York.
authors.forename: Jacob
authors.initials: J
authors.lastname: Franco
authors.affiliation: Pediatric Urology Associates, Tarrytown, New York.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Harding
authors.affiliation: Pediatric Urology Associates, Tarrytown, New York.
authors.forename: Dina
authors.initials: D
authors.lastname: Rosconi
authors.affiliation: Pediatric Urology Associates, Tarrytown, New York.
authors.forename: Emily
authors.initials: E
authors.lastname: Cupelli
authors.affiliation: Pediatric Urology Associates, Tarrytown, New York.
authors.forename: Therese
authors.initials: T
authors.lastname: Collett-Gardere
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D003248:Constipation / Q000453:epidemiology; D053159:Dysuria / Q000453:epidemiology; D057286:Electronic Health Records; D005242:Fecal Incontinence / Q000453:epidemiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology*; D006801:Humans; D007182:Income; D008297:Male; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D012621:Seasons; D012737:Sex Factors; D012959:Socioeconomic Factors; D001745:Urinary Bladder Diseases / Q000453:epidemiology*; D014549:Urinary Incontinence / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology
keywords: LUTS; constipation; dysuria; fecal soiling; frequency; income; urgency