The Importance of Obesity and Socio-demographic Properties in Children with Nocturnal Enuresis Diagnosis
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Introduction: Urinary incontinence during sleeping is a common condition in children older than four years. This is called nocturnal enuresis. In this study, we aimed to evaluate the sociodemographic characteristics of children with nocturnal enuresis and its relationships with etiology, diagnosis, treatment, and obesity. Materials and Methods: 692 patients diagnosed with primary nocturnal enuresis were screened retrospectively and included in the study. Their families were interviewed and asked to fill out the questionnaire form. This questionnaire form contained questions about gender, family history of nocturnal enuresis, frequency of nocturnal enuresis, presence of encopresis or constipation, monthly income, number of siblings, age at initiation of toilet training, sleep assessment, history of previous treatment, and perspective of families on their children’s medication use, height, and weight. The relationship of these variables with nocturnal enuresis was evaluated. Findings: Of the 692 patients included in the study, 262 (37.8%) were female and 430 (62.2%) were male. The mean age was 9.2 (5-16) years. 112 (16.1%) patients had a family history of nocturnal enuresis. 241 (34.9%) patients wet the bed every day, 341 (49.3%) patients wet the bed two or three days per week, 62 (8.9%) patients wet the bed one day per week or less, and 48 (6.9%) wet the bed one day per month or less. While 96 (13.8%) patients had accompanying chronic constipation, 13 (1.8%) patients had accompanying encopresis. The families of 386 (55.8%) patients had a monthly income of less than 1000 TL, the families of 214 (30.9%) patients had a monthly income between 1000-2000 TL, and the families of 92 (13.3%) patients had a monthly income of 2000 TL or over. When the number of siblings in the family was examined, 52 (7.6%) patients had no siblings, 394 (56.9%) patients had 4 or more siblings. When age at initiation of toilet training was examined, 534 (73.9%) patients received toilet training between the ages of 2 and 5 years. According to sleep assessment, 360 (52.1%) patients slept deeply. 338 (48.8%) patients received previous treatment. While the families of 358 (51.7%) patients took a positive approach to medication initiation, the families of 334 (48.3%) patients were hesitant to medication initiation due to medication side effects. According to body mass index (BMI) category, 262 (37.9%) patients were lean, 364 (52.7%) patients were normal weight, 42 (6%) patients were overweight, and 24 (3.4%) patients were obese. Conclusion: Nocturnal enuresis is an important health problem that adversely affects children. In order to solve this problem, it is necessary to raise family awareness about nocturnal enuresis, to assess the socioeconomic status of the family, to determine whether there is a genetic predisposition in the family, and to reveal the presence of additional diseases in the child. The family should be adequately informed about the treatment. It should be explained to the family that nocturnal enuresis should be followed up. We think that there is a need for further studies on this subject.Keywords:
Encopresis
Etiology
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To assess the prevalence of overactive bladder (OAB) and nocturnal enuresis (NE) in early adolescents, we distributed an anonymous questionnaire about urinary symptoms to 624 middle school students aged 13 and 15 years. The questionnaire included items regarding age, gender, past and present diseases, urinary symptoms and bowel habits. OAB was defined as symptoms of increased daytime frequency occurring more than eight times during the daytime and/or urge incontinence occurring at least once a month. The overall response rate to the questionnaire was 32.4%, and the mean age +/- SD of all respondents was 13.9 +/- 0.89 years. The prevalence of OAB was 15.3% of all respondents (95% CI, 10.4-20.3%; 4.2-16.1% of boys and 12.5-28.3% of girls). The prevalence of OAB decreased with age from 17.6% of respondents aged 13-year-olds to 11.8% of 15-year-olds. The mean daytime frequency was 5.0 +/- 2.2 times. Increased daytime frequency was found in 10.4% (95% CI, 6.2-14.6%; 2.7-13.5% of boys and 6.1-19.0% of girls) and nocturia in 4.0% (95% CI, 1.3-6.7%). The prevalence of NE was 3.0% (95% CI, 0.65-5.4%; three boys and three girls). The results of this study demonstrate that some early adolescents had OAB or NE. Further large-scale studies would be required to investigate the prevalence and natural history of OAB and NE.
Nocturia
Urinary urgency
Prevalence
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<b><i>Objective: </i></b>Parental and child co-sleeping has been suggested as a risk factor for short sleep duration and poor sleep quality that may lead to overweight. We examined if joining parent's bed during night was associated with child overweight. <b><i>Methods: </i></b>Cross-sectional data from the ‘Healthy Start' study including 635 2- to 6-year-old Danish children, who were all considered obesity prone. Of these, 496 children had complete information on BMI and whether the child joined parents' bed during night and if so, how frequently. International cut-offs for overweight according to age and gender were applied, and logistic regression was used to estimate odds ratio (OR) and 95% Confidence Intervals (CI). Analyses were adjusted for the child's age and gender, overall family stress, parental educational level, and parental BMI. <b><i>Results: </i></b>Children who did not join their parent's bed were more likely to be overweight compared to children who did (OR 1.75 (95% CI 0.99-3.10)). Children who rarely joined their parents' bed had OR 2.74 of being overweight (95% CI 1.01-7.44) compared to children who joined every night. <b><i>Conclusion:</i></b> Children who rarely joined parents' bed during night were almost three times more likely to be overweight than those who joined every night.
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Urination
Cross-sectional study
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BACKGROUND It was previously reported that nocturnal enuresis (NE) is associated with obstructive sleep apnea syndrome (OSA) in children. The aim of this study was to elucidate whether NE and OSA were associated in community dwelling children in Japan. METHODS All the primary school children from grade 1 to 6 (i.e. 5/6 to 11/12 year old) of a certain city in Japan were enrolled. Questionnaires were delivered to their parents or care-takers and collected via all the areal schools. NE was defined as those who bed wetted frequently more than once a week. We also investigated the frequency of snoring and SDQ scores, as surrogate markers for OSA and anxiety, respectively. Co-variables included grade, physical constitute, adeno-tonsil hypertrophy, and asthmatic history. Multivariable logistic analyses were conducted using SAS ver 23.0 (SAS Institute inc, Chicago, IL). RESULTS 21,380 participants, 85.7% of total school children of the city, gave an analyzable response. We found that children who snored frequently were more likely to suffer NE. Other co-variables included lower grades, male, asthmatic history and anxiety were associated with the NE. DISCUSSION The study indicated that OSA and NE were associated, leading to their possible common pathogeneses. There were a few limitations; this was based on cross-sectional study, and thus did not elucidate the causal relations. In addition, some of the diagnoses might be clinically inaccurate as the study was to the parents or care-takers. However, only a restricted number of studies based on communities was available regarding this topic, while our study enrolled more than 21,000 children, with such a high response rate.
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Objective:The aim of the present study was to examine the relationship between nocturnal enuresis (NE) of childhood and nocturia of parents. Material and methods:The study was conducted across the network of general pediatricians of the ASL NA 1 of Naples, Italy.All the children with NE and their mothers were invited to attend the clinic for the study.Data were collected by personal interview.A 5-day bladder diary was collected from all the children.The mothers with nocturia were given a 3-day frequency-volume chart to assess the presence of nocturnal polyuria or reduced bladder capacity.Both children and mothers underwent a bladder ultrasound scan to measure the bladder wall thickness.Results: A total of 224 mothers (aged between 23 and 45 years, average 33.3±4.1 years) and their 225 children (aged between 7 and 13 years, average 8.35±1.81years) were investigated.Of the 224 mothers, 90 (40%) had nocturia, of which 55 (61%) clearly remembered that they had suffered from NE in childhood.Only 4 (11%) out of the 35 women without nocturia had NE (p<0.001).Children with persistence of NE beyond 11 years were more likely to have a parent with nocturia.Children with non-monosymptomatic NE were more likely to have mothers with nocturia (odds ratio (OR) 1.7, 95% confidence interval (CI) 1.2-7.1,p<0.01) or overactive bladder symptoms (OR 1.9, 95% CI 1.1-15.2,p<0.01). Conclusion:These data suggest that there is a link between NE in childhood and nocturia in adulthood.A strong relationship was found between overactive bladder in children and overactive bladder in their mothers.
Nocturia
Desmopressin
Polyuria
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Purpose: This study aimed to investigate the prevalence, risk factors, and effects of primary nocturnal enuresis (PNE) on physical and mental health in young adults in mainland China.Methods: An anonymous questionnaire was used to collect information including the sociodemographic characteristics, history of PNE, family history, daytime voiding symptoms, Pittsburgh Sleep Quality Index (PSQI) scores, Self-Esteem Scale (SES), and Self-Rating Depression Scale (SDS). A total of 22,500 university students from 23 provinces and 368 cities in mainland China were included.Results: In total, 21,082 questionnaires were collected, and 20,345 of them qualified for statistical analysis. The PNE prevalence was 1.17%, and the distribution of monosymptomatic nocturnal enuresis (MNE) and nonmonosymptomatic nocturnal enuresis (NMNE) was 66.1% and 33.9%, respectively. In total, 28% of respondents with PNE reported bedwetting daily, 31.6% between 1 and 7 times weekly, and 40.4% between 1 and 4 times monthly; 80% of PNE cases had no history of treatment. The prevalence of PNE in patients with a family history, frequency, urgency, urinary incontinence, and recurrent urinary tract infections was significantly higher than in those without these conditions (P<0.001). PNE was significantly correlated with the PSQI total score (sleep quality) (P=0.011). The SES score was lower and the SDS was higher (P<0.001) in the PNE group than in those without PNE.Conclusions: In mainland China, the PNE prevalence among young adults was found to be high, and PNE had significant effects on physical and mental health. Risk factors included a family history, daytime voiding symptoms, and lack of treatment.
Depression
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We performed a nationwide epidemiological study to evaluate the prevalence and characteristics of nocturnal enuresis (NE) in Korean adolescents and adults. A questionnaire was sent via e-mail to 51,073 people aged 16-40 yr by stratified sampling according to age, sex, and region among a 200,000 internet survey panel pool. The questionnaire included following information; presence or absence of NE, frequency of NE, possible risk factors for NE, self-esteem scale score and depression score results, and measures for the treatment of NE. Among the 2,117 responders, 54 (2.6%) had NE (≥1 enuretic episode within 6 months). Of 54 bedwetters, 9.3% wet ≥1 night per week and 20.5% wet ≥1 per month. The prevalence rates remained relatively stable with no apparent trend of reduction with age. The presence of sleep disturbance, family history, urgency, or urge incontinence increased the probability of NE episode significantly. The self-esteem score was lower (P=0.053) and the depression scale score was higher (P=0.003) in bedwetters compared with non-bedwetters. Overall 2.6% of Korean aged 16-40 yr have NE. The higher rate of urgency and urge incontinence in adolescent and adult enuretics suggests that bladder function has an important role in adolescent and adult NE.
Cross-sectional study
Depression
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Nocturnal enuresis (NE) is very common and is one of the most common causes for patients to be admitted to urology, pediatrics, child psychiatry and child surgery departments. We aimed to investigate the effect on depression and self-esteem of this disorder that can cause problems on person's social development and human relations.90 patients who were admitted to our clinic with complaints of nocturnal enuresis were enrolled. Investigations to rule out organic causes were performed in this group of patients. Out of them 38 children and adolescents (age range 8-18 years) with primary monosymptomatic nocturnal enuresis (PMNE) agreed to participate in the study In the same period 46 healthy children and adolescents with a similar age range without bed wetting complaint were included in the study as a control group. The age of the family, educational and socioeconomic level were questioned and Piers-Harris Children's Self-Concept Scale (PHCSCS) and Children's Depression Inventory (CDI) forms were filled out.Mean age of the cases (18 females or 47.4% and 20 males or 52.6%) was 10.76 ± 3.82 years whereas mean age of controls (26 females or 56.5% and 20 males or 43.5%) was 10.89 ± 3.11 years. Depression scale was significantly higher (p = 0.001) in the case group than in the control group (10.42 ± 4.31 vs 7.09 ± 4.35). In both groups there was no statistically significant difference by age and sex in terms of depression scale (p > 0.05).NE is widely seen as in the community and is a source of stresses either for children and for their families. When patients were admitted to physicians for treatment, a multidisciplinary approach should be offered and the necessary psychological support should be provided jointly by child psychiatrists and psychologists.
Depression
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Enuresis is a common problem among children and adolescents, and can lead to important social and psychological disturbances. The aim of the present study was to establish the prevalence of enuresis among school children and determine the risk factors associated with this disorder.A cross sectional population-based study was conducted in 1576 children. The pupils enrolled in the study were chosen randomly from 14 primary schools located in seven different regions of Istanbul. Data were collected via a questionnaire completed by parents. Enuretic children were invited to the pediatric nephrology outpatient clinic of Cerrahpasa Medical School, Istanbul, Turkey. A detailed history was taken, physical and ultrasonographic examinations, urinalysis and urine culture were performed. The relationship between the prevalence of enuresis and the patients' age, gender, region, the parental educational level and employment status, number of family members, and the family's monthly income were tested by means of chi(2 ) and logistic regression analysis. The comparison between the two enuretic groups (monosymptomatic nocturnal enuresis group vs diurnal enuresis only and diurnal-nocturnal enuresis group) regarding the sociodemographic factors were tested with the chi(2) test and P < 0.05 was accepted as statistically significant.The study group was composed of 1576 school children aged between 6 and 16 years. The overall prevalence of enuresis was 12.4%. When the chi(2) test was used, a significant relationship was found between the prevalence of enuresis and age, educational level of the father, the family's monthly income, and number of family members. However, when logistic regression analysis was applied, there was a statistically significant relationship only between enuresis, and age and number of family members. In the whole group, monosymptomatic enuresis nocturna was found to be more common in boys. When the two enuretic children groups (monosymptomatic nocturnal, diurnal only and nocturnal-diurnal enuretics) were compared with each other regarding gender, parental educational and employment status, and number of family members, statistically significant differences were found. Both maternal and the paternal low educational status were found to be associated with monosymptomatic enuresis nocturna. Likewise, monosymptomatic enuresis nocturna was found to be more common in the children of the unemployed mothers, while diurnal enuresis was more common in the children of unemployed fathers. Nocturnal enuresis was found to be associated with large families. No statistically significant difference was demonstrated between the two groups of enuretics regarding age and family income levels. The rate of urinary abnormalities in the whole group was 7.1%.Enuresis is a common problem among school children and associated urinary abnormalities are not uncommon. Identification of children at risk is an essential first step before choosing the individualized management for each enuretic child.
Family income
Cross-sectional study
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Nocturia
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