{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T03:58:15Z","timestamp":1777348695150,"version":"3.51.4"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100013238","name":"Faculty of Medicine Siriraj Hospital, Mahidol University","doi-asserted-by":"publisher","award":["R016032033"],"award-info":[{"award-number":["R016032033"]}],"id":[{"id":"10.13039\/501100013238","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pediatr"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Bladder and bowel dysfunction (BBD) is a common disorder in children that is often associated with psychosocial and behavioral problems. Data specific to BBD in Asian children are comparatively scarce. Accordingly, this study aimed to investigate the prevalence of BBD and the response to standard urotherapy among Thai children attending the general pediatric outpatient clinic of Siriraj Hospital \u2013 Thailand\u2019s largest national tertiary referral center.\u00a0<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Children aged 4\u201312\u00a0years were recruited to complete the Dysfunctional Voiding Symptom Score (DVSS) questionnaire to screen for BBD during 2018 to 2020. Standard urotherapy, which consists of education and behavior management, was prescribed to those with a DVSS score that suggests the presence of BBD. Enrolled children and their caregivers were followed-up at 3 and 6\u00a0months. The Strengths and Difficulties Questionnaire (SDQ) was completed at baseline. DVSS scores at baseline, and at 3\u00a0months and 6\u00a0months after standard urotherapy were compared using repeated measures analysis of variance (ANOVA).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 1,042 children completed the DVSS during the study period, and 90 (8.6%) were deemed to have BBD. The mean age of BBD children was 6.9\u2009\u00b1\u20092.2\u00a0years, and the female to male ratio was 2.9:1. The most common symptoms were defecation frequency (80.0%), difficult defecation (80.0%), curtsying (74.4%), urgency (68.9%), infrequent voiding (43.3%), and daytime incontinence (32.2%). Forty-one BBD children completed the SDQ, and 32.5% had scores suggestive of hyperactivity problems. Among the 24 BBD patients who were followed-up after 3 and 6\u00a0months of standard urotherapy, there was a significant improvement in DVSS results (9.5\u2009\u00b1\u20093.1 at baseline <jats:italic>vs.<\/jats:italic> 6.9\u2009\u00b1\u20093.4 at 3\u00a0months <jats:italic>vs.<\/jats:italic> 4.4\u2009\u00b1\u20093.9 at 6\u00a0months; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Nine of 12 patients with urinary incontinence showed complete response at 6\u00a0months. The overall Bristol stool score significantly improved from 2.6\u2009\u00b1\u20090.7 at baseline to 3.2\u2009\u00b1\u20091.0 at 6\u00a0months (<jats:italic>p<\/jats:italic>\u2009=\u20090.03).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>BBD is a prevalent condition among Thai children that is often associated with emotional and behavioral problems. Standard urotherapy prescribed in a general pediatric outpatient clinic setting yielded favorable outcomes in Thai children with BBD.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12887-022-03360-9","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T08:03:34Z","timestamp":1652774614000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Screening and management of bladder and bowel dysfunction in general pediatric outpatient clinic: a prospective observational study"],"prefix":"10.1186","volume":"22","author":[{"given":"Achra","family":"Sumboonnanonda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Punnarat","family":"Sawangsuk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patharawan","family":"Sungkabuth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janpen","family":"Muangsampao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walid A.","family":"Farhat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuntawan","family":"Piyaphanee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,17]]},"reference":[{"key":"3360_CR1","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1002\/nau.22751","volume":"35","author":"PF Austin","year":"2016","unstructured":"Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: Update report from the standardization committee of the International Children\u2019s Continence Society. Neurourol Urodyn. 2016;35:471\u201381.","journal-title":"Neurourol Urodyn"},{"key":"3360_CR2","doi-asserted-by":"publisher","first-page":"S64","DOI":"10.5489\/cuaj.4411","volume":"11","author":"JD Santos","year":"2017","unstructured":"Santos JD, Lopes RI, Koyle MA. Bladder and bowel dysfunction in children: An update on the diagnosis and treatment of a common, but underdiagnosed pediatric problem. Can Urol Assoc J. 2017;11:S64-s72.","journal-title":"Can Urol Assoc J"},{"key":"3360_CR3","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1016\/j.jpurol.2014.05.008","volume":"10","author":"S Y\u00fcksel","year":"2014","unstructured":"Y\u00fcksel S, Yurdakul A, Zencir M, \u00c7\u00f6rd\u00fck N. Evaluation of lower urinary tract dysfunction in Turkish primary schoolchildren: an epidemiological study. J Pediatr Urol. 2014;10:1181\u20136.","journal-title":"J Pediatr Urol"},{"key":"3360_CR4","doi-asserted-by":"publisher","first-page":"101","DOI":"10.3389\/fped.2016.00101","volume":"4","author":"C Sampaio","year":"2016","unstructured":"Sampaio C, Sousa AS, Fraga LG, Veiga ML, Bastos Netto JM, Barroso U Jr. Constipation and Lower Urinary Tract Dysfunction in Children and Adolescents: A Population-Based Study. Front Pediatr. 2016;4:101.","journal-title":"Front Pediatr"},{"key":"3360_CR5","doi-asserted-by":"publisher","first-page":"e20152982","DOI":"10.1542\/peds.2015-2982","volume":"137","author":"N Shaikh","year":"2016","unstructured":"Shaikh N, Hoberman A, Keren R, Gotman N, Docimo SG, Mathews R, et al. Recurrent Urinary Tract Infections in Children With Bladder and Bowel Dysfunction. Pediatrics. 2016;137:e20152982.","journal-title":"Pediatrics"},{"issue":"332","key":"3360_CR6","first-page":"e1","volume":"15","author":"MA \u00d6zen","year":"2019","unstructured":"\u00d6zen MA, Mutluer T, Necef I, Shabsog M, Ta\u015fdemir M, Bilge I, et al. The overlooked association between lower urinary tract dysfunction and psychiatric disorders: a short screening test for clinical practice. J Pediatr Urol. 2019;15(332):e1\u20135.","journal-title":"J Pediatr Urol"},{"key":"3360_CR7","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1007\/s00467-011-2028-1","volume":"27","author":"GT Vaz","year":"2012","unstructured":"Vaz GT, Vasconcelos MM, Oliveira EA, Ferreira AL, Magalh\u00e3es PG, Silva FM, et al. Prevalence of lower urinary tract symptoms in school-age children. Pediatr Nephrol. 2012;27:597\u2013603.","journal-title":"Pediatr Nephrol"},{"key":"3360_CR8","first-page":"9","volume":"100","author":"N Piyaphanee","year":"2016","unstructured":"Piyaphanee N, Sirikuntaramas S, Sumboonnanonda A, Farhat WA. Validity and Reliability of the Thai Version of Dysfunctional Voiding Symptom Score (DVSS) Questionnaire. J Med Assoc Thai. 2016;100:9\u201316.","journal-title":"J Med Assoc Thai"},{"key":"3360_CR9","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1016\/S0022-5347(05)67239-4","volume":"164","author":"W Farhat","year":"2000","unstructured":"Farhat W, B\u00e4gli DJ, Capolicchio G, O\u2019Reilly S, Merguerian PA, Khoury A, et al. The dysfunctional voiding scoring system: quantitative standardization of dysfunctional voiding symptoms in children. J Urol. 2000;164:1011\u20135.","journal-title":"J Urol"},{"key":"3360_CR10","doi-asserted-by":"publisher","first-page":"1842","DOI":"10.1097\/01.ju.0000058211.24641.66","volume":"169","author":"J Upadhyay","year":"2003","unstructured":"Upadhyay J, Bolduc S, B\u00c4Gli DJ, McLorie GA, Khoury AE, Farhat W. Use of the Dysfunctional Voiding Symptom Score to Predict Resolution of Vesicoureteral Reflux in Children With Voiding Dysfunction. J Urol. 2003;169:1842\u20136.","journal-title":"J Urol"},{"key":"3360_CR11","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1111\/j.1469-7610.1997.tb01545.x","volume":"38","author":"R Goodman","year":"1997","unstructured":"Goodman R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiat. 1997;38:581\u20136.","journal-title":"J Child Psychol Psychiat"},{"key":"3360_CR12","first-page":"128","volume":"19","author":"Y Wongpiromsarn","year":"2011","unstructured":"Wongpiromsarn Y, Wipulakorn P, Nuanmanee S, Woener W, Mongkol A. Strengths and Diffi culties Questionnaire (SDQ) Thai improved version: change and administration. J Ment Health Thai. 2011;19:128\u201334.","journal-title":"J Ment Health Thai"},{"issue":"4","key":"3360_CR13","doi-asserted-by":"publisher","first-page":"450.e1","DOI":"10.1016\/j.jpurol.2021.03.032","volume":"17","author":"R Wang","year":"2021","unstructured":"Wang R, Van den Heuvel M, Rickard M, El-Bardisi Y, Mistry N, Koyle M, et al. Neurodevelopmental and psychiatric disorders in pediatric bladder and bowel dysfunction. J Pediatr Urol. 2021;17(4):450.e1-450.e6.","journal-title":"J Pediatr Urol"},{"key":"3360_CR14","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.jpurol.2020.11.006","volume":"17","author":"AJ Nieuwhof-Leppink","year":"2021","unstructured":"Nieuwhof-Leppink AJ, Hussong J, Chase J, Larsson J, Renson C, Hoebeke P, et al. Definitions, indications and practice of urotherapy in children and adolescents: - A standardization document of the International Children\u2019s Continence Society (ICCS). J Pediatr Urol. 2021;17:172\u201381.","journal-title":"J Pediatr Urol"},{"key":"3360_CR15","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1016\/j.jpurol.2018.08.010","volume":"14","author":"R Jiang","year":"2018","unstructured":"Jiang R, Kelly MS, Routh JC. Assessment of pediatric bowel and bladder dysfunction: a critical appraisal of the literature. J Pediatr Urol. 2018;14:494\u2013501.","journal-title":"J Pediatr Urol"},{"issue":"376","key":"3360_CR16","first-page":"e1","volume":"15","author":"ER Dourado","year":"2019","unstructured":"Dourado ER, de Abreu GE, Santana JC, Macedo RR, da Silva CM, Rapozo PMB, et al. Emotional and behavioral problems in children and adolescents with lower urinary tract dysfunction: a population-based study. J Pediatr Urol. 2019;15(376):e1\u20137.","journal-title":"J Pediatr Urol"},{"key":"3360_CR17","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1016\/j.jped.2019.02.007","volume":"95","author":"GM Assis","year":"2019","unstructured":"Assis GM, Silva CPCD, Martins G. Urotherapy in the treatment of children and adolescents with bladder and bowel dysfunction: a systematic review. J Pediatr (Rio J). 2019;95:628\u201341.","journal-title":"J Pediatr (Rio J)"},{"key":"3360_CR18","first-page":"13","volume":"15","author":"K Afshar","year":"2021","unstructured":"Afshar K, Dos Santos J, Blais AS, Kiddoo D, Dharamsi N, Wang M, et al. Canadian Urological Association guideline for the treatment of bladder dysfunction in children. Can Urol Assoc J. 2021;15:13\u20138.","journal-title":"Can Urol Assoc J"}],"container-title":["BMC Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-022-03360-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12887-022-03360-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-022-03360-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T08:03:43Z","timestamp":1652774623000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpediatr.biomedcentral.com\/articles\/10.1186\/s12887-022-03360-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,17]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["3360"],"URL":"https:\/\/doi.org\/10.1186\/s12887-022-03360-9","relation":{},"ISSN":["1471-2431"],"issn-type":[{"value":"1471-2431","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,17]]},"assertion":[{"value":"16 February 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 May 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The protocol for this study was approved by the Siriraj Institutional Review Board (SIRB) of the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand (COA no. Si 441\/2017), and was in compliance with the principles and guidelines set forth in the 1964 Declaration of Helsinki and all of its subsequent amendments. Verbal assent and written informed consent to participate in this study was obtained from study children and their parent\/caregiver\/legal guardian, respectively.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare no personal or professional conflicts of interest relating to any aspect of this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"288"}}