ABSTRACT Purpouse: One of the many artificial intelligence based tools that has gained popularity is the Chat-Generative Pre-Trained Transformer (ChatGPT). Due to its popularity, incorrect information provided by ChatGPT will have an impact on patient misinformation. Furthermore, it may cause misconduct as ChatGPT can mislead physicians on the decision-making pathway. Therefore, the aim of this study is to evaluate the accuracy and reproducibility of ChatGPT answers regarding urological diagnoses. Materials and Methods: ChatGPT 3.5 version was used. The questions asked for the program involved Primary Megaureter (pMU), Enuresis and Vesicoureteral Reflux (VUR). There were three queries for each topic. The queries were inserted twice, and both responses were recorded to examine the reproducibility of ChatGPT's answers. Afterwards, both answers were combined. Finally, those rwere evaluated qualitatively by a board of three specialists. A descriptive analysis was performed. Results and Conclusion: ChatGPT simulated general knowledge on the researched topics. Regarding Enuresis, the provided definition was partially correct, as the generic response allowed for misinterpretation. For VUR, the response was considered appropriate. For pMU it was partially correct, lacking essential aspects of its definition such as the diameter of the dilatation of the ureter. Unnecessary exams were suggested, for Enuresis and pMU. Regarding the treatment of the conditions mentioned, it specified treatments for Enuresis that are ineffective, such as bladder training. Therefore, ChatGPT responses present a combination of accurate information, but also incomplete, ambiguous and, occasionally, misleading details. Purpouse ChatGenerative Chat Generative PreTrained Pre Trained ChatGPT. . (ChatGPT) misinformation Furthermore decisionmaking decision making pathway Therefore diagnoses Methods 35 3 5 3. used pMU, , (pMU) VUR. VUR (VUR) topic twice ChatGPTs s Afterwards combined Finally specialists performed Conclusion topics correct misinterpretation appropriate ureter suggested mentioned ineffective training incomplete occasionally details (ChatGPT (pMU (VUR

ABSTRACT Purpose: Parasacral Transcutaneous Electrical Stimulation (TENS) is one of the treatments for children with Bladder and Bowel Dysfunction (BBD). Some studies showed that children with increased Rectal Diameter (RD) have more Functional Constipation (FC). However, RD prediction in maintenance of BBD after treatment was never evaluated. Our aim is to evaluate the association between RD and response to treatment in children and adolescents with BBD. Materials and Methods: This study evaluated patients from 5-17 years old with BBD. Dysfunctional Voiding Scoring System (DVSS), Rome IV criteria, and the Constipation Score were used. RD was measured using abdominal ultrasound before treatment according to the technique established by Klijn et al. and was considered enlarged when >3cm. No laxatives were used during treatment. Descriptive analysis and binary regression were performed and the area under the ROC curve was calculated. Results: Forty children were included (mean age 8.4±2.8 years, 52.5% male). Before treatment, RD was enlarged in 15 children (37.5%) (mean diameter 3.84±0.6cm), with FC persisting post-treatment in 11/15(73.3%). Those patients also required more laxatives following treatment and had more severe FC. Binary regression showed pretreatment RD to be an independent predictor of the persistence of FC post-treatment (OR=9.56; 95%CI:2.05-44.60). In ROC curve analysis, the sensitivity was 100% (95%CI: 0.49-1.0) and specificity 77.14% (95%CI:0.60-0.90) for rectal diameter >3 cm. The likelihood ratio was 4.38 (95%CI:2.40-8.0) for the persistence of BBD following treatment. Conclusion: RD appears to be relevant in the evaluation of children with BBD, not only as a diagnostic tool but also as a predictor of treatment outcome. Purpose TENS (TENS . (BBD) (RD (FC) However Methods 517 5 17 5-1 DVSS, DVSS , (DVSS) criteria al 3cm cm >3cm calculated Results mean 8428 8 4 2 8.4±2. 525 52 52.5 male. male male) 1 37.5% 375 37 (37.5% 3.84±0.6cm, 38406cm 3.84±0.6cm 3 84 0 6cm 3.84±0.6cm) posttreatment post 11/1573.3%. 1115733 11/15 73.3% 11 73 11/15(73.3%) OR=9.56 OR956 OR 9 56 (OR=9.56 95%CI2.0544.60. 95CI2054460 CI 95%CI 2.05 44.60 95 05 44 60 95%CI:2.05-44.60) 100 95CI (95%CI 0.491.0 04910 0.49 1.0 49 0.49-1.0 7714 77 14 77.14 95%CI0.600.90 95CI060090 0.60 0.90 90 (95%CI:0.60-0.90 > 438 38 4.3 95%CI2.408.0 95CI24080 2.40 8.0 40 (95%CI:2.40-8.0 Conclusion outcome (BBD (FC 51 5- (DVSS 842 8.4±2 52. 37.5 (37.5 1573 11/1573.3% 111573 1115 11/1 733 73.3 7 11/15(73.3% OR=9.5 OR95 (OR=9.5 CI2 0544 95%CI2.0544.60 95CI205446 205 2.0 4460 44.6 6 95%CI:2.05-44.60 10 491 0.491. 0491 049 0.4 1. 0.49-1. 771 77.1 CI0 600 95%CI0.600.9 95CI06009 060 0.6 090 0.9 (95%CI:0.60-0.9 43 4. 408 95%CI2.408. 95CI2408 240 2.4 80 8. (95%CI:2.40-8. 8.4± 37. (37. 157 11/1573.3 11157 111 11/ 73. 11/15(73.3 OR=9. OR9 (OR=9. 054 95%CI2.0544.6 95CI20544 20 2. 446 44. 95%CI:2.05-44.6 0.491 04 0. 0.49-1 77. 95%CI0.600. 95CI0600 06 09 (95%CI:0.60-0. 95%CI2.408 95CI240 24 (95%CI:2.40-8 8.4 (37 11/1573. 11/15(73. OR=9 (OR=9 95%CI2.0544. 95CI2054 95%CI:2.05-44. 0.49- 95%CI0.600 95CI060 (95%CI:0.60-0 95%CI2.40 95CI24 (95%CI:2.40- (3 11/1573 11/15(73 OR= (OR= 95%CI2.0544 95CI205 95%CI:2.05-44 95%CI0.60 95CI06 (95%CI:0.60- 95%CI2.4 95CI2 (95%CI:2.40 ( 11/157 11/15(7 (OR 95%CI2.054 95CI20 95%CI:2.05-4 95%CI0.6 95CI0 (95%CI:0.60 95%CI2. (95%CI:2.4 11/15( 95%CI2.05 95%CI:2.05- 95%CI0. (95%CI:0.6 95%CI2 (95%CI:2. 95%CI2.0 95%CI:2.05 95%CI0 (95%CI:0. (95%CI:2 95%CI:2.0 (95%CI:0 95%CI:2. 95%CI:2 95%CI:

ABSTRACT Introduction: Lower urinary tract dysfunction (LUTD) is a common clinical condition. Emotional and behavioral issues are increasing among children and adolescents, with stress indicating difficulties in personal and social functioning. This study evaluated whether urinary tract symptoms (LUTS) is associated with stress. Materials and Methods: A cross-sectional, analytical study with 6-14-year-old patients with LUTS and no anatomical/neurogenic urinary tract abnormalities was conducted using the Dysfunctional Voiding Scoring System, a psychological assessment and the Child Stress Scale. The overall stress score was analyzed in relation to the psychological assessment data. Answers to the seven specific DVSS urinary questions were compared with those for the four Child Stress Scale domains. Univariate and multivariate analyses were performed. The chi-square test and Pearson's correlation were used to determine associations. Significance was defined as p <0.05. Results: Most children were male (56%). Mean age was 9.0±2.25 years. Stress was detected in 20 out of 98 patients (20.4%; 95% CI: 13-30%). Of these, 90% were born from unplanned pregnancies and 67% were upset about their disorder. All the Child Stress Scale domains were significantly associated with urinary dysfunction, with dysuria being significantly associated with all four domains. In the multivariate analysis, dysuria was the only symptom that remained associated with stress. Associations with stress strengthened as the frequency of dysuria increased: physical reactions (p <0.01), emotional reactions (p <0.05), psychological reactions with a depressive component (p <0.01) and psychophysiological reactions (p <0.05). Conclusion: Stress levels are higher in children and adolescents with LUTS who have more severe symptoms. Dysuria was the symptom most associated with stress, both in the physical reactions domain, in the psychological reactions domains with or without a depressive component and in the psychophysiological reactions domain.

ABSTRACT Purpose To identify which independent variable would be strong predictor of febrile urinary tract infection (UTI) in children and adolescents with overactive bladder. Materials and Methods A search was made of the institute's database for all patients diagnosed with overactive bladder over the preceding four years. Children and adolescents under 18 years of age with overactive bladder and no neurological or anatomical alterations of the lower urinary tract were included in the study. The independent variables were: sex, age, ethnicity (Brazilians of African descendence/others), the presence of urinary urgency, daytime incontinence, enuresis, frequent urination, infrequent voiding (≤3 voids/day), nocturia, holding maneuvers, straining to void, intermittent urinary flow, constipation and encopresis. An analysis was conducted to identify patients with febrile UTI and subsequently determine predictors of this condition. Univariate and multivariate analyses were performed. Results Overall, 326 patients (214 girls/112 boys) were evaluated. The mean age of the patients was 7.7±3.19 years (± standard deviation). The incidence of febrile UTI was 39.2%. Being female and infrequent voiding were factors significantly associated with febrile UTI, both in the univariate and multivariate analyses. Conclusions These results show that being female and infrequent voiding constituted significant risk factors for a diagnosis of febrile UTI in these children.