Abstract General Information

Title

PREVALENCE AND RISK FACTORS OF LOWER URINARY TRACT SYMPTOMS IN RURAL CHILDREN AND ADOLESCENTS

Introduction and objective

Lower urinary tract symptoms (LUTS) are common in clinical practice and are one of the main diseases that seriously affect the physical and mental health of children and adolescents. The literature on LUTS is mostly focused on young children and adults, while there is limited research on the prevalence and related factors of LUTS in children and adolescents, especially in rural areas. Therefore, conducting an analysis of LUTS among rural children and adolescents and investigating related factors will help to understand the current situation of LUTS among rural children and adolescents and the impact of related factors. The purpose of this study is to investigate and analyze the prevalence and related influencing factors of lower urinary tract symptoms in rural children and adolescents.

Method

From September 2020 to December 2022, a random sampling method was used to conduct an epidemiological survey on 4100 middle and primary school students in a certain area of Henan Province. The questionnaire includes the age, gender, height, place of birth, early care methods, caregivers, lifestyle habits, defecation and urination habits, personal hygiene behavior, LUTS status in the past month, intestinal symptoms, and other admission criteria of the research subjects: full-time primary and secondary school students; Voluntary participants in this study; To prevent related drugs from influencing the investigation results, it is required that those who have not taken drugs for Urinary system diseases in recent 2 months and are in good health through routine physical examination at school. Exclusion criteria: children with mental or Nervous system disease; Chronic urinary system diseases; History of urological or pelvic organ surgery; The content of the questionnaire does not match before and after filling; The missing content in the questionnaire is greater than 20%. To analyze whether the prevalence of children and adolescents with urgency of urination, frequency of urination, daytime urinary incontinence (DUI), nocturnalenuresis (NE), and overall LUTS is related to the educational background of the caregiver, the child's gender, whether to use diapers until the age of 1 after birth, the time to start urinating, whether to have Toilet training, whether to have a history of UTI, whether to have constipation, and other factors.

Results

A total of 3885 valid questionnaires were collected, with an effective response rate of 94.76%. The incidence rate of LUTS in children and adolescents gradually declined with age. The prevalence of LUTS in children aged 6-12 years old declined rapidly. The prevalence of urgency of urination in children aged 6 years old was 31.55%, the frequency of urination was 26.20%, NE was 16.34%, and DUI was 17.75%; At the age of 12, the incidence of urinary urgency decreased to 12.68%, urinary frequency was 6.48%, NE was 3.66%, and DUI was 3.38%; After the age of 12, the downward trend of LUTS significantly slows down. By the age of 16, the incidence of urinary urgency decreased to 9.14%, urinary frequency was 5.14%, NE was 1.14%, and DUI was 1.14%. The prevalence rate of male urgent urination, frequency of urination, DUI and NE was higher than that of female (P<0.001). The prevalence rate of LUTS in children who used diapers for more than one year after birth was higher than that in children who did not use diapers or used diapers for less than one year after birth (P<0.001). The prevalence rate of LUTS in children who received urine training before the age of one year was lower than that in children who started after the age of one year (P<0.001). The incidence of urgent urination, frequency of urination, DUI and NE was affected by not receiving Toilet training (P<0.001) Constipation was associated with urgency, frequency, DUI, and NE (P<0.05). Include the above single factor meaningful indicators (P<0.05) in the multivariate logistic regression analysis. The results showed that men, previous UTI history and constipation were the risk factors for urgency of urination, frequency of urination, DUI and NE (OR>1, P<0.05). The time of using diapers after birth<1 year old or not using diapers, starting urine training before 1 year old and receiving Toilet training were the protective factors for urgency of urination, frequency of urination, DUI and NE (OR<1, P<0.05). Multiple factor logistic regression analysis of LUTS and the above influencing factors: gender, whether to use diapers to ≥ 1 year old after birth, time to start urinating, whether to have Toilet training, whether to have a history of UTI, and whether to have constipation showed that male, previous history of UTI, and constipation were risk factors for LUTS (OR>1, P<0.05), and the time to use diapers after birth was less than 1 year old or not to use diapers Urinary training and Toilet training before the age of one year were protective factors for LUTS (OR<1, P<0.05).

Conclusion

The prevalence of LUTS among rural children and adolescents is relatively high. The risk factors of LUTS were still using diaper after 1 year old, history of urinary tract infection (UTI), not receiving Toilet training, constipation and abnormal prepuce. Conducting urine training before the age of 1 is a protective factor for LUTS.