IS UROLOGICAL DYSFUNCTIONS IN YOUNG WOMEN AN INHERITANCE OF CHILDHOOD?

One of the most interesting area of research in urology is the correlation between childhood and adult lower urinary tract dysfunctions (LUTD). The aim of our study is to evaluate if the LUTD in women 18-40 years old, may be the result of previous pediatric LUTD. These results may identify the probable “risk conditions”. This is a multicenter prospective case-control study registered on the ClinicalTrials.gov (NCT02185287). Women referred to urological clinics were divided in 2 groups: healthy volunteer (group A) and patient (group B). Inclusion criteria were: age 18 to 40 years and any UD. Exclusion criteria were: diabetes mellitus, neurological disease, pelvic inflammatory disease, vaginal delivery ¼2 and baby with birth weight ¼4 kg. All women completed a self-administered 77-item questionnaire. It consists of 2 parts: I) explores the female urological and bowel history until the age of 14, II) refers to the current urological, bowel, and sexual history. Statistical analysis was performed using the non parametric MannWhitney U test and X2 test. P value <0.05 was considered significant. 254 women were enrolled, 134 in group A and 120 in the group B, both groups are comparable for demographic characteristics. The graph shows the percentage of LUTDs present in both groups in adult and pediatric age. Group A had fewer LUTDs in childhood than group B (27.6% vs 60% p¼0.001). In the entire sample 73.6% of women with childhood episodes of urinary incontinence (UI) will be incontinent as adults (p<0.001); 68.7% of children with voiding symptoms will have them as adults (p<0.001), in particular 56.5% and 68% of girls who voided with straining and with interrupted flow respectively will develop a voiding dysfunction as adults (p<0.001). Increased urinary frequency (with more than 7 daytime voids) and urgency during childhood seem to be related to urinary frequency disturbances (p¼0.04) and urgency symptoms (p¼0.001) respectively in the adulthood. LUTDs during childhood are correlated to LUTDs in adulthood, in fact adulthood voiding and storage symptoms and UI are significantly related to the presence of the same problems during the childhood. Girls with LUTDs should be carefully monitored to identify treatment or prevention strategy and confirming the need of a strict collaboration between pediatrics and urologists.