Bladder Symptoms in Children with Functional Constipation: A Systematic Review

Objective: To perform a systematic review of the literature examining the prevalence of bladder symptoms in children with functional constipation (FC), and to compare the prevalence of those symptoms between children with and without FC. Methods: In this systematic review 4 databases were searched to July 2018. Studies investigating the prevalence of bladder symptoms in children aged 4 to 17 years with FC were included. There was no language restriction. Two reviewers independently extracted data and assessed study quality. Clinical heterogeneity between studies was investigated. Prevalence rates of bladder symptoms in children with FC were calculated. Relative risks were calculated to compare the prevalence of bladder symptoms between children with and without FC. Results: Among 23 studies of children with FC, 22 reported the prevalence bladder symptoms (12,281 children) and 7 reported the prevalence of urinary tract infections (UTI) (687 children). The prevalence rates of single bladder symptoms, lower urinary tract symptoms (LUTS), and UTI varied between 2%–47%, 37%–64%, and 6%–53%. The relative risks were 1.24–6.73 for 20 single bladder symptoms (12 studies) and 2.18–6.55 for UTI (2 studies). The 95% confidence intervals indicated significance in 14 of 20 single bladder symptoms. Conclusions: Bladder symptoms seem common in children with FC, but the reported prevalence varies greatly. Children with FC are more likely to have bladder symptoms than children without FC. We recommend that clinicians be aware of concomitant bladder symptoms in children presenting with FC. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. https://ift.tt/OBJ4xP Address correspondence and reprint requests to Marjolein Y. Berger, MD, PhD, Department of General practice and Elderly care medicine, PO Box 196, 9700 AD Groningen, The Netherlands (e-mail: m.y.berger@umcg.nl). Received 25 May, 2018 Accepted 7 August, 2018 Funding source: All phases of this study were supported by a grant of the P.W. Boer foundation for education and research in urology, the Netherlands. Financial disclosure: The funding organization had no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. Prospero protocol registration: PROSPERO 2016:CRD42016045742, https://ift.tt/2p6ztny Conflicts of interest: The authors have no conflicts of interest disclose. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.jpgn.org). © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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