Screening and Management of Bladder and Bowel Dysfunction Among Toilet Trained Children in a General Pediatric Outpatient Clinic of a Tertiary Hospital Using Standard Urotherapy: Prospective Interventional Study

Melanie O. Uy Matiao, Maria Rosario F. Cabansag, Remedios D. Chan, Maria Margarita M. Romano, Jemely M. Punzalan, Dennis Flores, David T. Bolong

Apr 2026 DOI 10.35460/2546-1621.2025-0256     Access   

Abstract

Background: Bladder bowel dysfunction (BBD) is a prevalent yet underdiagnosed condition in toilet-trained children. Early detection and behavioral management through standard urotherapy are key to improving outcomes, but data on its effectiveness in the Filipino pediatric population are limited.

Objective: This study determined the prevalence of BBD among toilet-trained children attending a tertiary hospital’s pediatric outpatient clinic, and to evaluate the effectiveness of standard urotherapy among affected children.

Methods: A prospective interventional study was conducted among 144 toilet-trained children aged 7 to 12 years seen at the University of Santo Tomas Hospital outpatient clinic from August 2025 to September 2025. Sociodemographic data were collected, and BBD was screened using the validated Filipino version of the Dysfunctional Voiding Symptom Scores (DVSS) questionnaire. Children with BBD underwent standard urotherapy, which included behavioral and lifestyle interventions such as timed voiding, adequate hydration, constipation management and proper voiding posture. DVSS assessments were repeated at two and four weeks.

Results: The overall prevalence of BBD was 22.9% (33 of 144). BBD was significantly more prevalent among females (31.88%) than males (14.67%) (adjusted OR = 2.96, 95% CI: 1.28–6.86; p = 0.011). At baseline, children with BBD had significantly higher mean total DVSS scores (9.15 ± 3.64) compared to those without (2.01 ± 1.80, p<0.001). After two weeks of standard urotherapy, DVSS scores significantly improved with a mean reduction of 6.38 points (p<0.001). Improvements were noted across items related to daytime incontinence, wetting, urgency and infrequent voiding. After four weeks, all patients who underwent treatment no longer met the DVSS criteria for BBD, demonstrating clinically significant recovery.

Conclusion: Standard urotherapy proved effective in reducing symptom scores within two weeks and resulted in complete clinical resolution after four weeks among those who continued therapy. Routine screenings for BBD using DVSS and early initiation of standard urotherapy in pediatric outpatient settings are recommended to prevent complications and improve children’s urinary and bowel health.

Key Words: Bladder bowel dysfunction, Dysfunctional voiding symptom score, Toilet trained Filipino children

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