The significance of the parents' description of constipation in pediatric voiding dysfunction

Purpose: Dysfunctional voiding is closely related to constipation, and accurate evaluation of constipation is important. We investigated the accuracy and reliability of several methods that are used to evaluate constipation. Materials and Methods: We collected data from the parents of 168 dysfunctional voiders, and the data was collected using the Bristol stool form scale and the Leech method. We then analyzed the results of the questionnaire and compared them with the Paris Consensus on Childhood Constipation Terminology (PACCT). Results: Among the 168 dysfunctional voiders, 71 (42%) were diagnosed with constipation according to PACCT. Of the 39 children who were considered constipated, none were constipated according to PACCT. However, 35 of the 129 children whose parents denied they were constipation were in fact diagnosed with constipation. When the Leech method and the Bristol stool form scale were both used, the sensitivity of diagnosis rose to as high as 75%, and when the statement of the guardian was added, the sensitivity rose to as high as 85%. Conclusions: Since constipation can be a rather subjective condition, it would be appropriate to respect and incorporate the parents' statement into the diagnosis. However, for making a more accurate diagnosis, comprehensive evaluation based on specific symptoms and the Bristol stool form scale and the Leech method may be helpful.