Can pre-treatment dysfunctional voiding and incontinence scoring system score predict treatment outcome in children with dysfunctional voiding - a randomized trial

Abstract

Introduction/Objective. Dysfunctional Voiding and Incontinence Scoring System (DVISS) was created to help diagnose functional voiding disorders in children based on their clinical symptoms. However, its role in prognosticating treatment outcome in dysfunctional voiding (DV) was not explored. The aim was to analyze the pre-treatment DVISS score?s ability to predict treatment outcomes in a pediatric population with DV. Methods. A total of 86 patients were divided into two groups at random. In addition to standard urotherapy, group A also received pelvic floor and diaphragmatic breathing exercises, while group B only received standard urotherapy. Initial and final DVISS scores for the 12-month treatment period were recorded. Both before and after the treatment, uroflowmetry with pelvic floor electromyography were performed together with residual urine volumes measurement. The treatment outcome (non-, partial and full response) was defined according to the objective improvement in daytime and nighttime wetting, constipation, urinary infections and uroflowmetry findings. The cut-off values, sensitivity, and specificity of the pre-treatment DVISS score in predicting non/partial and full response in group A and B were determined using Receiver Operating Characteristic (ROC) curve analysis. Results. Pre-treatment DVISS score could not predict full response in both groups (the area under the ROC curve < 0.50) nor non-/ partial response in A group (p = 0.127). In B group, sensitivity and specificity of the initial DVISS score (cut-off value 9.5) in prediction of non-/partial response was 73.1% and 33.3%, respectively (p = 0.043). Conclusion. DVISS cannot be used in the treatment result prediction in DV.