Lower urinary tract symptoms in adults treated for vesico-ureteral reflux in childhood, compared to healthy controls

Objective: To compare lower urinary tract (LUT) symptoms in young adults with previous vesico-ureteral reflux (VUR) and healthy controls. VUR is associated with LUT dysfunction in childhood but less is known regarding long-term prognosis. Methods: A questionnaire was sent to 483 patients treated for VUR between 1993 and 2003 and a control group of 640 healthy young adults. Presence of LUT symptoms was compared by multivariable logistic regression, expressed as odds ratios (OR) and 95% confidence intervals (CI), adjusting for age, sex and body mass index. Results: The study group response rate was 45.8% versus 41.9% in the controls. There was a female predominance in both groups (77.9% and 74.3%). Overall, 45.7% of the VUR group and 36.6% of the controls reported current LUT symptoms, with unspecified LUT symptoms being significantly more common (OR = 3.86, 95% CI 1.33–11.20), especially in individuals receiving single treatment, and women without a pregnancy history. A larger proportion of those with VUR reported childhood incontinence than controls (20.4% vs. 5.6%, OR = 3.86, 95% CI 1.53–9.79). There were no significant differences in pyelonephritis during adulthood, yet individuals in the VUR group tended to have a higher micturition frequency than controls. Conclusion: Bladder dysfunction related to VUR during early childhood seems to improve with age, yet voiding difficulties and a higher micturition frequency appeared to remain more common in adults, predominantly females, with previous reflux than in healthy controls.