Impact of posterior urethral valve on patient quality of life and caregiver burden

Abstract

BackgroundAmong the wide range of congenital kidney and urinary tract anomalies, posterior urethral valve (PUV) has most devastating complications such as recurrent urinary tract infections, urinary incontinence, and chronic kidney disease. To assess the quality-of-life (QoL) of children with PUV, determine the factors contributing to reduced patient's QoL and increased caregiver burden.MethodsA total of 36 boys with PUV and 54 healthy controls aged between 4 and 18 years were included. Both groups completed the Children's Health Related Quality of Life (KINDL). Children with PUV also completed ICIQ-CLUTS incontinence questionnaire. Caregivers of PUV patients completed Impact on Family Scale (IOFS) to assess caregiver burden.ResultsBoys with PUV aged between 7 and 18 years old had significantly lower total QoL scores and lower scores in physical well-being, emotional well-being, self-esteem, family interactions, social interactions and school subscales compared to healthy controls. Patients who underwent multiple surgeries had lower emotional wellbeing scores than those with a single surgery. Among PUV patients, enuresis was associated with lower physical wellbeing score, daytime incontinence with lower emotional wellbeing and urge incontinence with lower school scores. Higher lower urinary tract symptom severity was correlated higher IOFS total scores, including familial/social impact and personal strain subscales.ConclusionBoys aged 7-18 years with PUV experience lower QoL than healthy peers. Lower urinary tract symptoms are a major contributing factor to both reduced QoL in patients and increased caregiver burden. Early and effective management of lower urinary tract symptoms may improve QoL of PUV patients and lower caregiver burden.