Vol. 45 (6): 1167-1179, November – December, 2019
Ana Aparecida Nascimento Martinelli Braga 1, Maria Luiza Teixeira Veiga 1, Maria Gabrielle Correia da Silva Ferreira 1, Hellen Maciel Santana 1, Ubirajara Barroso Jr. 1
1 Centro de Distúrbios Urinários em Crianças (CEDIMI), Escola Bahiana de Medicina e Universidade Federal da Bahia, Salvador, Bahia, Brasil
Introduction: Lower urinary tract dysfunction (LUTD) is a common clinical condition.
Emotional and behavioral issues are increasing among children and adolescents, with stress indicating diffi culties in personal and social functioning. This study evaluated whether urinary tract symptoms (LUTS) is associated with stress.
Materials and Methods: A cross-sectional, analytical study with 6-14-year-old patients with LUTS and no anatomical/neurogenic urinary tract abnormalities was conducted using the Dysfunctional Voiding Scoring System, a psychological assessment and the Child Stress Scale. The overall stress score was analyzed in relation to the psychological assessment data. Answers to the seven specifi c DVSS urinary questions were compared with those for the four Child Stress Scale domains. Univariate and multivariate analyses were performed. The chi-square test and Pearson’s correlation were used to determine associations. Signifi cance was defi ned as p <0.05.
Results: Most children were male (56%). Mean age was 9.0±2.25 years. Stress was detected in 20 out of 98 patients (20.4%; 95% CI: 13-30%).Of these, 90% were born from unplanned pregnancies and 67% were upset about their disorder. All the Child Stress Scale domains were signifi cantly associated with urinary dysfunction, with dysuria being signifi cantly associated with all four domains. In the multivariate analysis, dysuria was the only symptom that remained associated with stress. Associations with stress strengthened as the frequency of dysuria increased: physical reactions (p <0.01), emotional reactions (p <0.05), psychological reactions with a depressive component (p <0.01) and psychophysiological reactions (p <0.05).
Conclusion: Stress levels are higher in children and adolescents with LUTS who have more severe symptoms. Dysuria was the symptom most associated with stress, both in the physical reactions domain, in the psychological reactions domains with or without a depressive component and in the psychophysiological reactions domain.
Keywords: Urinary Bladder, Neurogenic; Stress Disorders, Traumatic; Adolescent