C-reactive protein levels in girls with lower urinary tract symptoms.
BACKGROUND
Daytime lower urinary tract (LUT) conditions are identified as daytime incontinence problems for children in whom any cause of neuropathy and uropathy has been excluded. C-reactive protein (CRP) is a common marker of acute or chronic inflammation and infection. Increased CRP levels have been detected in the studies conducted on adults diagnosed with overactive bladders and interstitial cystitis.


OBJECTIVE
This study aimed to investigate the role of serum CRP levels in girls suffering from daytime LUT conditions.


METHODS
Out of the 752 patients who presented to the outpatient clinics with lower urinary tract symptoms, 709 were excluded due to: being boys, having previous urinary tract surgery, an active urinary tract infection, a neurological anomaly, a urinary system anomaly, having rheumatic disease, any chronic disease, any febrile infection over the past week, a history of constipation, and enuresis nocturna. Forty-three girls with LUT conditions and aged 8-10 years were included in the study as the patient group. Forty girls who attended the urology outpatient clinic without LUT conditions, or active urinary tract infections and any chronic disease requiring follow-up constituted the control group. Under the control of the parents, all subjects were asked to fill out 3-day voiding diaries. The voiding diaries identified frequency, urgency, urgency urinary incontinence, and functional bladder capacity data. All subjects also completed a dysfunctional voiding scoring system (DVSS). The serum CRP levels of all subjects were measured.


RESULTS
There was a significant difference in serum CRP levels and DVSS between the patient group and the control group (P = 0.001, P = 0.001). The mean serum CRP levels showed a significant increase when frequency and urgency scores were ≥8, the urge incontinence score was ≥2 and the DVS score DVSS was ≥14 in the voiding diaries of the patient group (Table).


CONCLUSIONS
Lower urinary tract dysfunction is defined as a condition involving abnormalities of filling and/or emptying of the bladder. This frequently encountered problem constitutes >40% of all pediatric urology outpatient visits. The relationship between LUT conditions and serum CRP in both genders has been detected. However, it is believed that to our knowledge, this is the first study looking at the relationship between daytime LUTS and increased CRP levels in children. The most important limitations of the study were: having a small number of patients, and the sample consisting of only one gender and a specific age group.


CONCLUSIONS
The serum CRP levels were significantly higher in the girls with daytime LUT conditions than in the control group. Also, the CRP levels significantly increased as DVSS, frequency, urgency, and urge incontinence scores increased.
Department of Urology, Tepecik Training and Research Hospital, Izmir, Turkey. Electronic address: drhuseyintarhan@gmail.com.
H
H
Tarhan
Department of Urology, Tepecik Training and Research Hospital, Izmir, Turkey. Electronic address: gokhanekin@gmail.com.
R G
RG
Ekin
Department of Urology, Tepecik Training and Research Hospital, Izmir, Turkey. Electronic address: drertancan@yahoo.com.
E
E
Can
Department of Urology, Tepecik Training and Research Hospital, Izmir, Turkey. Electronic address: drozgurcakmak577@yahoo.com.
O
O
Cakmak
Department of Pediatrics, Tepecik Training and Research Hospital, Izmir, Turkey. Electronic address: oyavascan@hotmail.com.
O
O
Yavascan
Department of Pediatrics, Tepecik Training and Research Hospital, Izmir, Turkey. Electronic address: ftmnefro@yahoo.com.
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F
Mutlubas Ozsan
Department of Pediatrics, Tepecik Training and Research Hospital, Izmir, Turkey. Electronic address: mhelvaci@tepecikhastanesi.gov.tr.
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M
Helvaci
Department of Urology, Tepecik Training and Research Hospital, Izmir, Turkey. Electronic address: ferruhzorlu@gmail.com.
F
F
Zorlu
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000097:blood* / Q000503:physiopathology; D008297:Male; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D001743:Urinary Bladder / Q000503:physiopathology*; D014554:Urination / Q000502:physiology*
D015415:Biomarkers; D002097:C-Reactive Protein
C-reactive protein; CRP; Children; Daytime lower urinary tract condition