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Liu X, Wang Z, Zhou Z, Yang S, Yang J, Wen Y, Zhang Y, Lv L, Hu J, Wang Q, Lu W, Wen JG. Prevalence, risk factors, psychological effects of children and adolescents with lower urinary tract symptoms: a large population-based study. Front Pediatr 2024; 12:1455171. [PMID: 39233869 PMCID: PMC11371695 DOI: 10.3389/fped.2024.1455171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 08/07/2024] [Indexed: 09/06/2024] Open
Abstract
Background Lower urinary tract symptoms (LUTS) are clinically frequent and seriously affect the psychological and mental health of children and adolescents. However, most studies on LUTS and its influence on the psychological behavior and mental health have focused on adults. This study aimed to investigate LUTS prevalence and associated factors in children and adolescents and explore its impact on psychological behavior. Materials and methods From October 2019 to November 2021, an epidemiological LUTS survey was carried out on 6,077 children aged 6-15 years old in 12 primary and secondary schools in China by using anonymous questionnaires. Results A total of 5,500 valid questionnaires were collected, and the total prevalence of four representative symptoms of LUTS: urgency, frequency, daytime urinary incontinence, and nocturnal enuresis was 19.46%, 14.55%, 9.75%, and 8.4%, respectively. The prevalence decreased with age, which decreased rapidly in children aged 6-12 years old. The incidence of LUTS in those who did not continue to use disposable diapers (DD) and began to perform elimination communication (EC) after the age of 1 was significantly higher than that of those who stopped using DD and started EC before 1 year of age (P < 0.05). There were significant differences in the occurrence of LUTS without toiled training (TT) (P < 0.05). The prevalence of LUTS in males was significantly higher than in females (P < 0.05). LUTS in children and adolescents with constipation was significantly higher compared to those without constipation (P < 0.05). The detection rate of abnormal psychological behavior in the LUTS group was 44.6%, which was significantly higher than that in the no LUTS group (21.4%, P < 0.05). The scores of emotional symptoms, conduct problems, hyperactivity, and peer communication problems were significantly higher in the LUTS group than the control group. Conclusions In Mainland China, the prevalence of LUTS in children and adolescents is high. Continued use of DD after 1 year of age, history of urinary tract infection, lack of TT, and constipation were risk factors for LUTS. EC before 1 year of age is a protective factor for LUTS. The prevalence of psychological behavioral abnormalities is high in children and adolescents with LUTS, which needs to be more concerned.
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Affiliation(s)
- Xingchen Liu
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Joint International Paediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhan Wang
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Joint International Paediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhaokai Zhou
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Joint International Paediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shuai Yang
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Joint International Paediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jing Yang
- Surgical Reception Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yibo Wen
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Joint International Paediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yanping Zhang
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Joint International Paediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lei Lv
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Joint International Paediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jinhua Hu
- Department of Urology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Qingwei Wang
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Joint International Paediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Wei Lu
- Department of Urology, Xinyang Central Hospital, Xinyang, Henan, China
| | - Jian Guo Wen
- Paediatric Urodynamic Centre and Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Joint International Paediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Department of Urology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
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Hervé F, Vande Walle J, Raes A, Haddad R, Monaghan T, Drake MJ, Kamperis K, Dossche L, Zipkin J, Weiss J, Verbakel I, Bou Kheir G, Everaert K. The role of renal circadian biorhythms in lifelong LUTS. Neurourol Urodyn 2024; 43:1109-1117. [PMID: 37846751 DOI: 10.1002/nau.25308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023]
Abstract
INTRODUCTION This article delves into the intricate relationship between kidney function, diuresis, and lower urinary tract symptoms (LUTS) throughout the transitions of the human lifespan. It explores circadian regulation of urine production, maturation of renal function from birth to adulthood, and effects of aging on kidney function and LUTS. The complex connections between these factors are highlighted, offering insights into potential interventions and personalized management strategies. METHODS An international panel of seven experts engaged in online discussions, focusing on kidney function, diuresis, and LUTS throughout life. This manuscript summarizes expert insights, literature reviews, and findings presented during a webinar and subsequent discussions. RESULTS Renal function undergoes significant maturation from birth to adulthood, with changes in glomerular filtration rate, diuresis, and tubular function. A circadian rhythm in urine production is established during childhood. Adolescents and young adults can experience persistent enuresis due to lifestyle factors, comorbidities, and complex physiological changes. In older adults, age-related alterations in kidney function disrupt the circadian rhythm of diuresis, contributing to nocturnal polyuria and LUTS. CONCLUSION The interplay between kidney function, diuresis, and LUTS is crucial in understanding lifelong urinary health. Bridging the gap between pediatric and adult care is essential to address enuresis in adolescents and young adults effectively. For older adults, recognizing the impact of aging on renal function and fluid balance is vital in managing nocturia. This holistic approach provides a foundation for developing innovative interventions and personalized treatments to enhance quality of life for individuals with LUTS across all stages of life.
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Affiliation(s)
- François Hervé
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - Johan Vande Walle
- Department of Pediatric Nephrology, ERKNET Centre, Ghent University Hospital, Ghent, Belgium
| | - Ann Raes
- Department of Pediatric Nephrology, ERKNET Centre, Ghent University Hospital, Ghent, Belgium
| | - Rebecca Haddad
- GRC 001 GREEN Neuro-Urology Research Group, Sorbonne Université, Rothschild Academic Hospital, AP-HP, Paris, France
| | - Thomas Monaghan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Marcus J Drake
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - Konstantinos Kamperis
- Department of Pediatric and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lien Dossche
- Department of Pediatric Nephrology, ERKNET Centre, Ghent University Hospital, Ghent, Belgium
| | - Jacob Zipkin
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Jeffrey Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Irina Verbakel
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - George Bou Kheir
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
| | - Karel Everaert
- Department of Urology, ERN Accredited Centrum, Ghent University Hospital, Ghent, Belgium
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Breinbjerg A, Kamperis K, Thorsteinsson K, Jørgensen CS, Dossche L, Rayner J, Zhang J, Rodrigues DG, Borch L, Hagstrøm S, Tekgül S, Walle JV, Rittig S. Discontinuing absorbent pants in children with bedwetting: a randomized controlled trial. Eur J Pediatr 2024; 183:2443-2453. [PMID: 38472381 PMCID: PMC11035460 DOI: 10.1007/s00431-024-05502-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/01/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024]
Abstract
The objective of this study is to examine the effect of discontinuing wearing protective garments (absorbent pyjama pants - APP) in children with severe childhood nocturnal enuresis (NE). The study employs a multicenter, parallel, randomized controlled trial. Following a 4-week run-in period, participants were randomly allocated in a 2:1 group allocation to discontinue or continue using APP. The research was conducted across seven European pediatric incontinence centers. The study included treatment-naïve children aged 4-8 years with severe (7/7 wet nights per week) mono-symptomatic NE, who had used nighttime protection for at least 6 months prior to the study. The study consisted of a 4-week run-in period (± 7 days), where all children slept wearing APP (DryNites®). At week 4 (± 7 days), if meeting randomization criteria (7/7 wet nights during the last week of run-in), participants were randomized to continue to sleep in APP or to discontinue their use for a further 4 weeks, with the option of another 4 weeks in the extension period. The primary outcome was the difference between groups of wet nights during the last week of intervention. Quality of life (QoL) and sleep were secondary endpoints. In total, 105 children (43 girls and 62 boys, mean age 5.6 years [SD 1.13]) were randomized (no-pants group n = 70, pants group n = 35). Fifteen children (21%) in the no-pants group discontinued early due to stress related to the intervention. Children in the no-pants group experienced fewer wet nights compared to the pants group during the last week (difference 2.3 nights, 95% CI 1.54-3.08; p < 0.0001). In the no-pants group, 20% responded to the intervention, of whom 13% had a full response. Clinical improvement was detected within 2 weeks. Sleep and QoL were reported as negatively affected by APP discontinuation in the extension period but not in the core period. Conclusion: A ~ 10% complete resolution rate was associated with discontinuing APP. While statistically significant, the clinical relevance is debatable, and the intervention should be tried only if the family is motivated. Response was detectable within 2 weeks. Discontinuing APP for 4-8 weeks was reported to negatively affect QoL and sleep quality. No severe side effects were seen.Trial registration: Clinicaltrials.gov Identifier: NCT04620356; date registered: September 23, 2020. Registered under the name: "Effect of Use of DryNites Absorbent Pyjama Pants on the Rate of Spontaneous Resolution of Paediatric Nocturnal Enuresis (NE)."
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Affiliation(s)
- Anders Breinbjerg
- Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens blvd. 99, 8200, Aarhus N, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Konstantinos Kamperis
- Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens blvd. 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Kristina Thorsteinsson
- Department of Pediatrics and Adolescent Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Cecilie Siggaard Jørgensen
- Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens blvd. 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lien Dossche
- Department of Pediatric Nephrology, ERKNET center, Ghent University Hospital, Ghent, Belgium
| | - Juliette Rayner
- ERIC, The Children's Bowel and Bladder Charity, 36 Old School House, Kingswood Foundation, Brittania Rd, Bristol, BS15 8DB, UK
| | - Jin Zhang
- Global Product Safety, Stewardship & Medical Affairs, Kimberly-Clark Corporation, Tadworth, UK
| | - Debora Garcia Rodrigues
- Global Product Safety, Stewardship & Medical Affairs, Kimberly-Clark Corporation, Tadworth, UK
| | - Luise Borch
- Department of Pediatric and Adolescent Medicine, Gødstrup Hospital, Herning, Denmark and NIDO, Centre for Research and Education, Gødstrup Hospital, Herning, Denmark
| | - Søren Hagstrøm
- Department of Pediatrics and Adolescent Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Serdar Tekgül
- Division of Pediatric Urology, Department of Urology, Medical School, Hacettepe University, Ankara, Turkey
| | - Johan Vande Walle
- Department of Pediatric Nephrology, ERKNET center, Ghent University Hospital, Ghent, Belgium
| | - Søren Rittig
- Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens blvd. 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Carvalho TA, Vasconcelos MMDA, de Bessa J, Bastos JM, Dutra MF, Guimarães ICDO, Lima EM, Silva ACSE, Mrad FCDC. Relationship between primary monosymptomatic enuresis and process toilet training: a case-control. Int Braz J Urol 2022; 48:944-951. [PMID: 36173406 PMCID: PMC9747032 DOI: 10.1590/s1677-5538.ibju.2022.0381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/05/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Primary monosymptomatic nocturnal enuresis (PMNE) is a prevalent condition in childhood, and the pathophysiology is multifactorial. This study investigated the relationship between the toilet training process (TT) and PMNE in children and adolescents. PATIENTS AND METHODS A case-control study was carried out from 2015 to 2020. The presence of PMNE was identified according to International Children's Continence Society criteria. A semi-structured questionnaire was applied to assess TT. RESULTS The study included 103 children and adolescents with PMNE and 269 participants with normal psychomotor development without PMNE (control group [CG]). Readiness signals were more remembered and less frequent in participants with PMNE (p=0.001) when compared to control group. No differences were found between the groups regarding the onset age of the daytime TT (p= 0.10), the nocturnal TT (p=0.08), the acquisition of daytime continence (p=0.06), and the type of equipment used for the TT (p=0.99). The use of Child-Oriented approach in group of children with enuresis was lower than in controls [87.4% (90/103) versus 94% (250/266)], respectively (OR= 0.44, 95% CI 0.21-0.94, p = 0.039). CONCLUSIONS The age of onset of TT, acquisition of daytime continence, and the type of equipment were not associated with higher occurrence of PMNE. On the other hand, the Child-Oriented approach was a protective factor for the occurrence of PMNE.
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Affiliation(s)
- Tânia Antunes Carvalho
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Mônica Maria de Almeida Vasconcelos
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - José de Bessa
- Universidade Estadual de Feira de SantanaDepartamento de UrologiaFeira de SantanaBABrasilDepartamento de Urologia, Universidade Estadual de Feira de Santana (UFFS), Feira de Santana, BA, Brasil
| | - José Murillo Bastos
- Universidade Federal de Juiz de ForaFaculdade de MedicinaDepartamento de UrologiaJuiz de ForaMGBrasilDepartamento de Urologia, Faculdade de Medicina, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brasil,Faculdade de Ciências Médicas de Juiz de ForaMaternidade Therezinha de JesusDepartamento de UrologiaJuiz de ForaMGBrasilDepartamento de Urologia, Maternidade Therezinha de Jesus, Faculdade de Ciências Médicas de Juiz de Fora, Juiz de Fora, MG, Brasil
| | - Melissa Faria Dutra
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Isabela Cristina de Oliveira Guimarães
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Eleonora Moreira Lima
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | - Ana Cristina Simões e Silva
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil,Universidade Federal de Minas GeraisLaboratório Interdisciplinar de Investigação MédicaBelo HorizonteMGBrasilLaboratório Interdisciplinar de Investigação Médica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Flávia Cristina de Carvalho Mrad
- Universidade Federal de Minas GeraisFaculdade de MedicinaDepartamento de PediatriaBelo HorizonteMGBrasilDepartamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil,Correspondence address: Flávia Cristina de Carvalho Mrad, MD Depart. de Pediatria, Unidade de Nefrologia Pediátrica, Fac. de Med., Univ. Federal de Minas Gerais (UFMG) Avenida Alfredo Balena 190. sala 267, Santa Efigênia Belo Horizonte, MG, 30130-100, Brasil E-mail:
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Yu JT, Mao QF, Ji FP, Zhao Y, Hu HJ, Zhang YP, Yang J, Wang QW, Lu W, Wen JG. Delayed elimination communication is a crucial factor in disposable diaper dependence in Chinese preschool-aged children. Front Pediatr 2022; 10:1053118. [PMID: 36699294 PMCID: PMC9869372 DOI: 10.3389/fped.2022.1053118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Abstract
PURPOSE Elimination communication (EC) is considered to be a milestone in a child's development. Nowadays, a trend toward an older age at EC initiation has been observed globally, probably due to the convenience of disposable diaper use in daily life. The study aimed to identify potential risk factors for disposable diaper dependence (DDD) and evaluate whether an early/proper EC can reduce the risk of DDD among children in China. METHODS A cross-sectional study was performed on 13,500 children in mainland China from October 2019 to March 2020. An anonymous questionnaire was used to collect information including the sociodemographic characteristics, details about DDD and EC, and the effect of DDD on the quality of life of children. Data were analyzed by SPSS and R software. RESULTS The overall prevalence of DDD was 4.17% (4.31% in boys; 4.02% in girls) and decreased with age, from 8.71% at 2 years to 0.73% at 6 years (χ 2 trend = 210.392, P < 0.001). In univariable analysis, age, location or EC were associated with DDD. Four independent factors-age, location (urban), caregivers with high education levels (junior college or above) and delayed EC (after 12 months of age)-were identified to be significantly associated with DDD risk in logistic regression model. Compared with EC onset after 12 months of age, EC onset before 12 months of age was associated with a 79.6% (model 2) reduction in DDD. Four independent factors were selected to establish the nomogram for DDD based on the results of logistic regression analysis. The C-index (0.770) and the AUC (>0.7) indicated satisfactory discriminative ability of the nomogram. The calibration diagrams showed favorable consistency between the prediction of the nomogram and actual observations. CONCLUSION Our findings indicate the joint contribution of age, location, caregivers' education level and EC to DDD in Chinese preschool-aged children. Timely cessation of the use of disposable diapers and early/proper EC may help to reduce the risk of DDD in children.
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Affiliation(s)
- Jia-Ting Yu
- Henan Joint International Pediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qiu-Fang Mao
- Department of Urology, Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Feng-Ping Ji
- Henan Joint International Pediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying Zhao
- Department of Urology, Nursing School Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Hui-Jie Hu
- Department of Humanities Nursing, Sanquan College, Xinxiang Medical University, Xinxiang, China
| | - Yan-Ping Zhang
- Henan Joint International Pediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Yang
- Henan Joint International Pediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qing-Wei Wang
- Henan Joint International Pediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wei Lu
- Department of Urology, Affiliated Xinyang Hospital, Zhengzhou University & Xinyang Central Hospital, Xinyang, China
| | - Jian Guo Wen
- Henan Joint International Pediatric Urodynamic Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Does the development and use of modern disposable diapers affect bladder control? A systematic review. J Pediatr Urol 2021; 17:463-471. [PMID: 34099398 DOI: 10.1016/j.jpurol.2021.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION AND OBJECTIVE During the last decades, the development of the modern disposable diaper (DD) has changed the way we diaper our children, as they are safe, easy to use, comfortable and easy to dispose, compared to cloth diapers used earlier. Concurrently, the age of initiating toilet training (TT) is rising. We aimed to investigate the connection between DD usage and the tendencies seen in TT and childhood urinary incontinence, with specific interest on studies evaluating the effect of diapering on enuresis. STUDY DESIGN A literature search was conducted in PubMed and Embase. A systematic literature search was conducted, revealing 309 studies in Embase and 269 studies in Pubmed. After removing duplicates, 400 studies were eligible for screening. All abstracts were screened, and 12 relevant abstracts where identified, but only eight studies were eligible. No prospective intervention studies specifically evaluating the effect of diaper on enuresis were identified. Literature on TT and diapers in general was identified using the respective search terms on both databases. RESULTS The eight studies identified showed a tendency towards diaper use being related to a delay on obtaining continence in children, but no secure conclusions can be made, as the literature is inadequate. DISCUSSION AND CONCLUSION Based on the available literature no secure conclusions can be drawn although an association is suggested. In order to evaluate the effect of diapers on incontinence, prospective randomized studies are needed.
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Delayed elimination communication on the prevalence of children's bladder and bowel dysfunction. Sci Rep 2021; 11:12366. [PMID: 34117301 PMCID: PMC8196082 DOI: 10.1038/s41598-021-91704-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/28/2021] [Indexed: 11/09/2022] Open
Abstract
To determine the prevalence of bladder and bowel dysfunction (BBD) and its relationship with delayed elimination communication (EC) in children. A cross-sectional study was carried out in kindergartens and primary schools in mainland China. A total of 10,166 children ranging from 4 to 10 years old were included. A total of 10,166 valid questionnaires were collected, and 409 children were diagnosed with BBD. The overall prevalence was 4.02% (409/10,166) and decreased with age, from 6.19% at age 4 to 1.96% at age 10. With the prolonged use of disposable diapers (DDs), the commencement of usage of EC in a child was significantly put off or delayed by parents, and the prevalence of BBD amongst these children increased (P < 0.001). The prevalence of BBD among children who stopped using DDs within the first 12 months and after more than 24 months was 2.79% and 4.38% respectively. Additionally, the prevalence among children who started EC within 12 months after birth and those who never engaged in EC was 1.36% and 15.71% respectively. Early introduction of EC and weaning of DD usage has a positive correlation with lower prevalence of BBD in children in China.
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Zhu B, Zou K, He J, Huang X, Zhu W, Ahmad Harb AK, Wang J, Luo A. Sleep Monitoring of Children With Nocturnal Enuresis: A Narrative Review. Front Pediatr 2021; 9:701251. [PMID: 34660477 PMCID: PMC8515414 DOI: 10.3389/fped.2021.701251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/26/2021] [Indexed: 01/12/2023] Open
Abstract
The purpose of this article is to provide a succinct summary of the sleep monitoring efforts that have been used in nocturnal enuresis (NE) and an overview of the knowledge that has accrued. This is not intended to be a comprehensive review, but rather is intended to highlight how polysomnography (PSG), a common sleep detection tool, has contributed to our understanding of NE, as arousal disorder is considered to be one of the important mechanisms. The authors have organized this report by analysis and display of different ingredients of PSG, starting with comparing the electroencephalogram (EEG) of controls and the enuretic children and then moving to evaluation of respiratory patterns of NE and comorbid disease obstructive sleep apnea (OSA). In addition, the authors' goal is to better understand the mechanism of NE by integrating various levels of sleep monitoring; those sleep-related clinical scale scores for NE are presented to date. Finally, we propose further research of NE to explore the microstructure alterations via PSG combined with EEG-fMRI or to use novel technology like portable device internet and deep learning strategy.
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Affiliation(s)
- Binbin Zhu
- Department of Anesthesia, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Kun Zou
- Department of Electrophysiology, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Jianhua He
- Department of Pediatric Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Xueqin Huang
- Department of Pediatric Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China.,Zhejiang Key Laboratory of Pathophysiology, Medical School of Ningbo University, Ningbo, China
| | - Weichao Zhu
- Department of Pediatric Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Ahmad Khaled Ahmad Harb
- Department of Anesthesia, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Jianhua Wang
- Department of Radiology, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Aiping Luo
- Department of Pediatric Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
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