Validity and reliability of Persian translated version of Pediatric Lower Urinary Tract Scoring System Questionnaire for Iranian children

  Background: Pediatric lower urinary tract scoring system (PLUTSS) is a questionnaire contains items for assessment of wetting episodes, voiding frequency and pattern. It is used for screening and evaluation of the response of children with lower urinary tract symptoms to therapy. We studied the validity and reliability of Persian translated version of this questionnaire among Iranian children.   Methods: One hundred and ninety-seven children aged 5-15 years with urinary tract infection, voiding dysfunction, enuresis were enrolled in this study. Thirty-three healthy age-matched children without urinary complaint were considered as controls. PLUTSS questionnaire was filled out for all children. Sonography was performed to rule out urogenital abnormalities. Internal consistency, test-retest reliability, and validity of the questionnaire were assessed using Cronbach’s alpha, intra-class correlation coefficient, and ANOVA test respectively. ROC curve was used to define cut-point and its validity in discrimination between groups. P-value < 0.05 was considered significant.   Results: The means for PLUTSS items were 6.8 (±5.4) for voiding dysfunction, 14.4(±5) for enuresis, 10.5(±7.8) for recurrent and 8.9(±6) for single urinary tract infection, and 1.9(±1.8) for controls (p<0.001). Cronbach’s alpha for the 14 items of questionnaire was 0.74. The intraclass coefficient correlation for assessing test-retest reliability was 0.82 (p<0.001). ROC curve showed cut point of 5 for differing case from controls with sensitivity of 97.0 and specificity of 74.9(p<0.001).   Conclusions: Persian translated PLUTSS has a proper validity and reliability as an instrument for screening children with urinary tract symptoms but some questions need to be changed in some way to be understandable by our culture.