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 as-sessment of wetting episodes, voiding frequency and pattern. It is used for screening and evaluation of the re-sponse of children with lower urinary tract symptoms to therapy. We studied the validity and reliability of Per-sian translated version of this questionnaire among Iranian children. Methods: One hundred and ninety-seven children aged 5-15 years with urinary tract infection, voiding dys-function, enuresis were enrolled in this study. Thirty-three healthy age-matched children without urinary com-plaint were considered as controls. PLUTSS questionnaire was filled out for all children. Sonography was per-formed to rule out urogenital abnormalities. Internal consistency, test-retest reliability, and validity of the ques-tionnaire were assessed using Cronbach’s alpha, intra-class correlation coefficient, and ANOVA test respective-ly. 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.