Comparison of a Voiding Diary with Clinical Management Tool as an Outpatient Screening Tool for Childhood Functional Voiding Disorders.

Objective To study the agreement of questionnaire-based assessment with voiding diary for differentiating primary mono-symptomatic nocturnal enuresis from voiding disorder in children. Methods Children 5-12 years old with bedwetting after exclusion of secondary enuresis were enrolled and parents filled a clinical management tool (CMT) questionnaire and a 48-hours voiding diary. Point prevalence and agreement of classification as primary mono-symptomatic nocturnal enuresis or voiding disorder were compared. Results Of 1276 children screened, 143 (11.2%) reported enuresis. Of 100 (82 males) children finally analyzed, constipation and positive family history occurred in 14% and 37%, respectively. Questionnaire-based assessment and voiding diary identified 65% and 71%, respectively as voiding disorder [Cohen's kappa 0.542 (95%CI: 0.367-0.717)]. Discordance of classification was noted in 20%. Voiding diary identified additional 7% cases of voiding disorder. Conclusion While CMT and voiding diary have moderate agreement, voiding diary should be used for cases screened negative by a questionnaire-based tool.