Bladder dysfunction in children with anorectal malformations: identification of risk factors and development of a predictive scoring tool.

IF 1.6 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2025-08-22 DOI:10.1007/s00383-025-06164-x

Arka Banerjee, Sukanya Vinchurkar, Adwait S Bendre, Rishabh Jain, Gayatri Munghate, Minnie Bodhanwala, Parag J Karkera

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引用次数: 0

Abstract

Purpose: To evaluate lower urinary tract symptoms (LUTS) in toilet-trained children with anorectal malformations (ARM), identify risk factors for neurogenic bladder dysfunction (NBD) and develop a scoring system to predict poor urological outcomes.

Methods: This retrospective study reviewed records and conducted interviews for lower urinary tract symptoms (LUTS) and bladder management strategies in ARM patients treated at our center between April 2014 and March 2019. Logistic regression analysis identified risk factors, while a scoring system was developed using the Number Needed to Treat (NNT) metrics.

Results: Out of 166 patients, 32.5% (n = 54) exhibited LUTS. High ARM significantly increased the risk of NBD (RR: 2.43; p < 0.0001). Additional risk factors included vertebral anomalies (RR: 1.66; p = 0.0486), prior bladder surgeries (RR: 2.68; p < 0.0001), and abdomino-perineal reconstruction (RR: 2.88; p < 0.0001). The developed scoring system, with a threshold score of ≥ 12, demonstrated a sensitivity of 70.4% and specificity of 76.8% for predicting NBD.

Conclusions: This study highlights the significant prevalence of NBD in ARM patients and identifies critical risk factors. The scoring system offers a practical tool for early risk stratification, aiding in timely interventions. Further prospective studies are needed to validate the scoring system and refine management strategies.

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患有肛门直肠畸形的儿童膀胱功能障碍：危险因素的识别和预测评分工具的发展。

目的：评估经如厕训练的肛门直肠畸形（ARM）患儿的下尿路症状（LUTS），识别神经源性膀胱功能障碍（NBD）的危险因素，并建立评分系统来预测不良泌尿预后。方法：本回顾性研究回顾了2014年4月至2019年3月在本中心治疗的ARM患者的记录，并对其进行了下尿路症状（LUTS）和膀胱管理策略的访谈。逻辑回归分析确定了风险因素，同时使用治疗所需数量（NNT）指标开发了评分系统。结果：166例患者中，32.5% （n = 54）出现LUTS。结论：本研究强调了NBD在ARM患者中的显著患病率，并确定了关键危险因素。该评分系统为早期风险分层提供了实用工具，有助于及时干预。需要进一步的前瞻性研究来验证评分系统和完善管理策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor