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Enuresis, Lower Urinary Tract Dysfunction and Teachers’ Perceptions: A School-based Survey. Indian Pediatr 2020. [DOI: 10.1007/s13312-020-1818-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Alhifthy EH, Habib L, Abu Al-Makarem A, AlGhamdi M, Alsultan D, Aldhamer F, Buhlagah R, Almubarak FM, Almufadhi E, Bukhamsin GM, Zadah MH. Prevalence of Nocturnal Enuresis among Saudi Children Population. Cureus 2020; 12:e6662. [PMID: 31966951 PMCID: PMC6964794 DOI: 10.7759/cureus.6662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Nocturnal enuresis (NE) is the involuntary urination that occurs while asleep after an age when bladder control at night is expected. It has a global incidence of 1.4%-28% among 6-12 years old children. The aim of this study is to show the prevalence, risk factors, types of provided treatment of enuresis among studied children in Kingdom of Saudi Arabia (KSA). Methods A cross-sectional descriptive study was carried out among Saudi children, 3-12 years of age, from different cities in Saudi Arabia, during the period from 20 October to 20 November 2019. Data was collected by using a pre-designed questionnaire that was distributed online and included questions designed to fulfill the study objectives. Results This study reported that 31.2% of Saudi children of the chosen ages are suffered from enuresis, the majority occurred at day and night by 55.1% while 43.9% occurred only at night. Participants described types of provided treatment as follows: behavioral modification was the most commonly used by 31.6% followed by pharmacological intervention (29.6%), bed-wetting alarm (6.8%), exercises to strengthen the bladder muscles (6.2%) and surgical intervention reported by 1.5% only. It was found that the improvement of enuresis on treatment occurred in 43.6% of cases. There was a significant reduction of the prevalence of NE with age (peak is 63.6% in 5-7 years old) but no significant correlation was found with gender (p = 0.104). However, there was a significant correlation with parent having history of NE (p = 0.001). Conclusion The study reported that 31.2% of children found to have nocturnal enuresis; 43.9% of those had nocturnal enuresis alone. There were no significant correlations between nocturnal enuresis and child gender while it significantly correlated with child's age and having a family history of NE. Behavioral modification therapy was the most commonly provided treatment followed by pharmacological intervention; improvement occurred in less than half of the cases with treatment.
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Affiliation(s)
- Elham H Alhifthy
- Clinical Sciences, Pediatrics, Developmental and Behavioural Pediatrics, Princess Nourah Bint Abdulrahman University, College of Medicine, Riyadh, SAU
| | | | | | | | | | | | | | | | | | | | - Maria H Zadah
- Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
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Shah S, Jafri RZ, Mobin K, Mirza R, Nanji K, Jahangir F, Patel SJ, Ejaz MS, Qaiser I, Iftikhar H, Aziz K, Khan W, Maqbool HS, Ahmed H. Frequency and features of nocturnal enuresis in Pakistani children aged 5 to 16 years based on ICCS criteria: a multi-center cross-sectional study from Karachi, Pakistan. BMC FAMILY PRACTICE 2018; 19:198. [PMID: 30547752 PMCID: PMC6293541 DOI: 10.1186/s12875-018-0876-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 11/19/2018] [Indexed: 11/24/2022]
Abstract
Background Nocturnal enuresis (NE) is a common symptom in children worldwide. International Children’s Continence Society (ICCS) defines enuresis as either mono-symptomatic, NE with lower urinary tract symptoms and NE with co-morbid conditions. The objectives of this study were to determine the frequencies and types of NE and associated symptoms and conditions in children aged 5 to 16 years based on ICCS criteria. Methods A multi-center cross sectional study was conducted between November 2012 and December 2013 in the primary care clinics of four hospitals in Karachi. Children aged five to fifteen years were included through consecutive sampling. Informed consent was obtained from the parents and a pre-coded semi-structured questionnaire was used to obtain the information. Data was entered on SPSS version 20.0 and multivariable logistic regression analysis was used for data analysis. Results Out of 429 children aged between five and sixteen years, 243(56.9%) were boys and the remaining 186(43.1%) were girls. One hundred and eighty three children (43%) had nocturnal enuresis (NE). Forty four (10.3%), had mono-symptomatic NE, 57(31.1%) had associated lower urinary tract symptoms (NE-LUTS), whereas 30 (16.3%) had NE with a co-morbid condition. Fifty two (28.4%) NE’s had at least one of both LUTS and a co-morbid condition. Out of the 246(57%) non-enuretic’s, 31(12.6%) had a LUTS, 95(38.6%) had a co-morbid condition and 57(23.2%) had at least one of both LUTS and a co-morbid condition. The remaining 63 (25.6%) were symptom free. Increased voiding frequency, urgency, dysuria, suprapubic pain and daytime incontinence were the LUTS significantly associated with NE. Co-morbid conditions significantly associated with NE included constipation, congenital defects, developmental delay, and learning and sleep problems. Conclusion Although NE can be an only symptom, it is often associated with lower urinary tract symptoms like dysuria, urgency, suprapubic pain, and daytime incontinence. Children presenting with NE often have co-morbid conditions like constipation, urinary tract infection, sleep disorders, and developmental delay. Many children presenting with these conditions as the primary complaint may also have NE. It should be addressed as unrecognized and untreated NE can cause additional morbidity and distress.
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Affiliation(s)
- Sameena Shah
- Department of Family Medicine, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Rabab Zehra Jafri
- Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA, USA
| | - Khalil Mobin
- Community Health Sciences, Karachi Medical and Dental College, Karachi Metropolitan Corporation, Karachi, Pakistan
| | | | - Kashmira Nanji
- Department of Family Medicine, Aga Khan University, Karachi, Pakistan
| | - Fatima Jahangir
- Department of Family Medicine, Ziauddin University Hospital, Karachi, Pakistan
| | | | - Muzamil Shabana Ejaz
- Dow Medical College, DOW University of Health Sciences, Baba-e-Urdu Road, Karachi, Pakistan
| | | | | | - Komal Aziz
- Saint Louis University, St Louis, MO, USA
| | - Wajiha Khan
- Department of Pediatrics, Aga Khan University, Karachi., Pakistan
| | - Humza S Maqbool
- UC, San Francisco - Fresno medical education program, California, USA
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Analyzing the Relationship Between Addiction to Video Gaming and Primary Monosymptomatic Nocturnal Enuresis in Children. Nephrourol Mon 2018. [DOI: 10.5812/numonthly.67291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Reddy NM, Malve H, Nerli R, Venkatesh P, Agarwal I, Rege V. Nocturnal Enuresis in India: Are We Diagnosing and Managing Correctly? Indian J Nephrol 2017; 27:417-426. [PMID: 29217876 PMCID: PMC5704404 DOI: 10.4103/ijn.ijn_288_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Nocturnal enuresis is a common problem affecting school-aged children worldwide. Although it has significant impact on child's psychology, it is always under-recognized in India and considered as a condition which will outgrow with advancing age. Nocturnal enuresis classified as primary or secondary and monosymptomatic or nonmonosymptomatic. Factors that cause enuresis include genetic factors, bladder dysfunction, psychological factors, and inappropriate antidiuretic hormone secretion, leading to nocturnal polyuria. Diagnosis consists of detailed medical history, clinical examination, frequency-volume charts, and appropriate investigations. The frequency-volume chart or voiding diary helps in establishing diagnosis and tailoring therapy. The first step in treating nocturnal enuresis is to counsel the parents and the affected child about the condition and reassure them that it can be cured. One of the effective strategies to manage enuresis is alarm therapy, but currently, it is not easily available in India. Desmopressin has been used in the treatment of nocturnal enuresis for close to 50 years. It provides an effective and safe option for the management of nocturnal enuresis. This review covers the diagnosis and management of nocturnal enuresis and introduces the concept of “bedwetting clinics” in India, which should help clinicians in the thorough investigation of bedwetting cases.
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Affiliation(s)
- N M Reddy
- Department of Urology, Rainbow Hospitals, Hyderabad, Telangana, India
| | - H Malve
- Medical Affairs, Ferring Pharmaceuticals Pvt. Ltd., Mumbai, Maharashtra, India
| | - R Nerli
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital and MRC, Belgaum, India
| | - P Venkatesh
- Department of Pediatric Urology, NU Hospitals, Bengaluru, Karnataka, India
| | - I Agarwal
- Department of Child Health Unit II, Christian Medical College, Vellore, Tamil Nadu, India
| | - V Rege
- Department of Pediatric Urology, Wadia Hospital for Children, Mumbai, Maharashtra, India
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Sarici H, Telli O, Ozgur BC, Demirbas A, Ozgur S, Karagoz MA. Prevalence of nocturnal enuresis and its influence on quality of life in school-aged children. J Pediatr Urol 2016; 12:159.e1-6. [PMID: 26778419 DOI: 10.1016/j.jpurol.2015.11.011] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 11/17/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE According to the ICCS definitions, enuresis is defined by an intermittent, wetting during sleep after organic causes have been ruled out with a minimum wetting frequency of once per month. Previous studies reported a prevalence rate of 9-12%. Eighty to 90% of enuresis cases are identified as primary enuresis and are based on genetic predisposition, biological and developmental factors. On the other hand, secondary enuresis frequently arises from psychological factors. In this study we aimed to determine the prevalence and associated factors of nocturnal enuresis (NE) among primary school children. METHOD We initiated a prospective cross-sectional epidemiological study from January 2013 to May 2013 by sending a questionnaire to parents of 4250 school children, aged 6-13 years. The questionnaire consisted of three parts. The first part investigated the demographic characteristics of the child and family, such as age, gender, number of siblings, and enuresis history of the parents and siblings. The second part consisted of questions about the presence and frequency of bedwetting, presence of constipation/fecal incontinence, and presence of daytime incontinence (DI). The last part surveyed school performance and the effect of enuresis on quality of life of parents and children. Logistic regression analyses were conducted to determine the significant predictive factors for NE. RESULTS The overall prevalence of enuresis was 9.52%. The prevalence of NE among boys and girls was 12.4% and 6.5%, respectively. Daytime incontinence was present in 18% of children. Of enuretic children, 59.2% had a positive family history of enuresis. Constipation was found in 13.2% of children with enuresis and there was no significant association between NE and the presence of constipation. In addition, 48% of enuretic children had poor school performance. CONCLUSIONS The current study demonstrated that age, male gender, parents' history of enuresis, and siblings' history of enuresis were significant predictive factors for NE. The majority of the parents did not have adequate interest in enuretic children and most of the children were not treated. Physicians should inform parents of enuretic children with the aim of solving this problem to prevent future issues and development of adulthood lower urinary tract symptoms (LUTS).
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Affiliation(s)
- Hasmet Sarici
- Department of Urology, Afyon Kocatepe University Faculty of Medicine, Afyon, Turkey
| | - Onur Telli
- Department of Pediatric Urology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Berat Cem Ozgur
- Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Arif Demirbas
- Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey.
| | - Senem Ozgur
- Department of Pediatrics, Sami Ulus Training and Research Hospital, Ankara, Turkey
| | - Mehmet Ali Karagoz
- Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey
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Nocturnal Enuresis among Nigerian Children and its Association with Sleep, Behavior and School Performance. Indian Pediatr 2015; 52:587-9. [PMID: 26244952 DOI: 10.1007/s13312-015-0680-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To study the association of nocturnal enuresis with sleep, behavior and school performance. METHODS Hospital-based, cross-sectional descriptive study of 216 children (?6-year-old) using structured questionnaire and behavioral tools. SETTING Two hospitals at Lucknow in Northern India. RESULTS Prevalence of enuresis was 37.0%. Nocturnal enuresis was significantly associated with abnormal behaviour (P=0.049) and poor sleep hygiene (P%0.05). School performance was not associated with enuresis. CONCLUSION Children with nocturnal enuresis were at an increased risk of behavioral problems and poor sleep hygiene.
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Prevalence of monosymptomatic nocturnal enuresis and its correlates in school going children of Lucknow. Indian J Pediatr 2013; 80:488-91. [PMID: 22941216 DOI: 10.1007/s12098-012-0870-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 08/06/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To determine the prevalence of primary monosymptomatic nocturnal enuresis (PMNE) and its correlates in school going children of Lucknow. METHODS It is a cross-sectional school based study conducted in a random sample of 1212 school going children of Lucknow belonging to the middle socioeconomic strata. Data was collected via questionnaire designed for parents. Detailed urological history was obtained and physical examination done in the children whose parents answered the questionnaire. The chi-square test was used to compare the categorical/dichotomous indicators and backward logistic regression was used to find out the significant risk factors for monosymptomatic nocturnal enuresis. RESULTS Study reports the prevalence of PMNE to be 12.6 % (95 % CI = 10.9-14.3 %) and significant association of enuresis with the presence of home conflicts(adjusted OR = 38.37, 95 % CI = 20.04-73.47), stress in children due to enuresis(adjusted OR = 10.86, 95%CI = 5.73-20.57), scolding(adjusted OR = 6.78,95%CI = 3.69-12.44), parental history of enuresis(adjusted OR = 3.57, 95%CI = 1.96-6.50), poor scholastic performance(adjusted OR = 2.88,95 % = 1.49-5.56), age 6-8 y (adjusted OR = 13.80,95%CI = 4.38-43.45) and living with single parent (adjusted OR = 0.34, 95%CI = 0.17-0.68). Prevalence of monosymptmatic nocturnal enuresis MNE was 17.9 % (p = 0.001) among children who were not exclusively breastfed till 6 mo of age in the index study. CONCLUSIONS Enuresis is a pediatric health problem with high prevalence. Parental awareness needs to be created about this condition.
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Mahmoodzadeh H, Amestejani M, Karamyar M, Nikibakhsh AA. Prevalence of nocturnal enuresis in school aged children: the role of personal and parents related socio-economic and educational factors. IRANIAN JOURNAL OF PEDIATRICS 2013; 23:59-64. [PMID: 23550208 PMCID: PMC3574993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Accepted: 02/17/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Nocturnal enuresis is a common psychosocial concern for both parents and children. In the present study we have determined the prevalence of nocturnal enuresis in Urmia, Iran children and associated personal and familial factors with this problem. METHODS A cross sectional epidemiological study for detection of nocturnal enuresis prevalence rate and evaluation of associated familial and personal factors in elementary school children (7-11 years old) from Urmia were investigated. The subjects were selected by cluster sampling method. Chi square test and logistic regression were used in univariate and multivariate respectively. FINDINGS Of the 1600 questionnaires distributed, 918 (57%) were completed and included in the final analysis. The rest, which were not filled by parents and also those out of our study age range were excluded. Gender of the subjects was almost equally distributed (48.6% males and 51.4% females). Prevalence of nocturnal enuresis was 18.7% (n = 172) and prevalence of day time incontinence was 5.5% (n=51). There was no significant gender difference between these two groups. Enuretics had crowded families, positive family history, low educational level of parents, jobless father, working mother, single parent, poor school performance, positive history of urinary tract infection (UTI). CONCLUSION Our results with enuresis prevalence and associated factors were comparable to other epidemiological studies from various countries. We found that Iranian families do not pay sufficient attention to their enuretic children.
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Affiliation(s)
| | - Morteza Amestejani
- Corresponding Author:Address: School of Medicine, Urmia University, Urmia, Iran. E-mail:
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