Objective: A prospective study was conducted to explore the relationship between severity of voiding dysfunction and quality of life in children with daytime urinary incontinence. Furthermore, we examined the correlation between the child’s perceptions to their parents.

Setting: Pediatric Urology outpatient clinic at the Stollery Children's Hospital, Edmonton, Canada

Methods: In the child with primarily daytime wetting and a non-neurogenic bladder, we analyzed the relationship between age, gender, and severity of voiding dysfunction as measured by the Dysfunctional Voiding Symptom Score (DVSS) and quality of life measured by the Pediatric Urinary Incontinence Quality of Life Score (PinQ). Thirty-two children (6 males, 26 females) aged 5-11 years (x¯ 8.13) and their parents completed the DVSS and PinQ. Voiding and stooling diaries as well as pad studies were also obtained.

Results: Parent and child scores for the DVSS and PinQ Scores were not significantly different. Child DVSS scores ranged from 3 - 21 (x¯ 12.63) whereas parent scores ranged from 3-20 (x¯ 12.75). PinQ were also not significantly different, with patient scores ranging from 8-62 (x¯ 37.03) and parent scores ranged from 15-61 (x¯ 37.72). Child age was inversely correlated with child DVSS score (r = - 0.383, p = 0.0310) and child PinQ Score (r = - 0.370, p = 0.037). The severity of the patients DVSS Score correlated well with their parents score (r = 0.509, p = 0.003) and the parents PinQ Score (r = 0.440, p = 0.012). Voiding and stooling diaries showed inconsistent results when compared with urological history. Open ended questioning revealed that parents worry about the impact wetting has on their child's feelings and self-esteem, feel angry and frustrated with their child's wetting, feel they need to be prepared at all times and have concerns about the school's reaction to their child's wetting. Children expressed feelings of embarrassment and frustration with their wetting; felt they missed out on things as a result of their wetting and worried about teasing as well as others noticing the wetting.

Conclusions: This prospective study confirms the severe impact that voiding dysfunction and urinary incontinence has on child, family dynamics and peer relations. Results illustrate the importance of early recognition and intervention to minimize the impact on the child and family.