Prevalence of enuresis nocturna among a group of primary school children living in Diyarbakır

SunCloud: A mobile application for children with urinary incontinence

BACKGROUND AND AIM

Urinary incontinence is an important problem with potentially adverse effects on the psychological, social and personality development of children. Today, with the developing technology, the use of information and communication technologies such as wearable technology, message services and mobile applications has become widespread in solving health problems. In this study, it was aimed to develop a mobile application that facilitates the follow-up of children, increases their compliance with treatment and ensures the continuity of communication between them and the health worker. The methodology, design and preliminary evaluation results of the mobile application are presented in this article.

METHODS

During the development process of the mobile application, the content was first created in line with the literature review. After the content was determined, the interface design was made on MS Word and Photoshop software. At this stage, six experts were consulted for content and design. The mobile application, finalised in design, was implemented on Android and IOS platforms. After the mobile application was created, 10 children and their families were interviewed.

RESULTS

Nine of the families (90%) found the developed mobile application useful and easy to use. Families' suggestions to improve the mobile application were to make it more interesting for children and to enrich its content.

CONCLUSION

In line with the feedback, the mobile application was updated and finalised. Preliminary results are promising that the developed mobile application can be used as an aid to treatment in children with urinary incontinence. With the mobile application developed, urotherapy training was not limited to the time they visited the hospital. This suggests that the mobile application can eliminate the problem of partial or omitted treatment. This research has shown that leveraging technology can be a good option to increase treatment success.

CLINICAL TRIAL NUMBER

NCT05815940.

Application of Machine Learning Techniques for Enuresis Prediction in Children

INTRODUCTION

 As a subset of artificial intelligence, machine learning techniques (MLTs) may evaluate very large and raw datasets. In this study, the aim is to establish a model by MLT for the prediction of enuresis in children.

MATERIALS AND METHODS

 The study included 8,071 elementary school students. A total of 704 children had enuresis. For analysis of data with MLT, another group including 704 nonenuretic children was structured with stratified sampling. Out of 34 independent variables, 14 with high feature values significantly affecting enuresis were selected. A model of estimation was created by training the data.

RESULTS

 Fourteen independent variables in order of feature importance value were starting age of toilet training, having urinary urgency, holding maneuvers to prevent voiding, frequency of defecation, history of enuresis in mother and father, having child's own room, parent's education level, history of enuresis in siblings, consanguineous marriage, incomplete bladder emptying, frequent voiding, gender, history of urinary tract infection, and surgery in the past. The best MLT algorithm for the prediction of enuresis was determined as logistic regression algorithm. The total accuracy rate of the model in prediction was 81.3%.

CONCLUSION

 MLT might provide a faster and easier evaluation process for studies on enuresis with a large dataset. The model in this study may suggest that selected variables with high feature values could be preferred with priority in any screening studies for enuresis. MLT may prevent clinical errors due to human cognitive biases and may help the physicians to be proactive in diagnosis and treatment of enuresis.

The evaluation of urinary incontinence in secondary school children and risk factors: An epidemiological study

AIM

Urinary incontinence is an important problem that can arise due to neurogenic or functional reasons and negatively affect the psychological, social and personality development of children. This study was conducted on secondary school students to determine the prevalence and risk factors of urinary incontinence at night and/or in the daytime.

METHODS

The study universe included all secondary school students attending public elementary schools in the city centre of Eskişehir (N = 34 000). Ethics Committee and Provincial Directorate of National Education approvals were obtained before conducting the study. A data collection form prepared by the researchers and a consent form were delivered in a sealed envelope to the parents via the students. The study data were collected over the period 09 May 2018-30 May 2018. A total of 6957 questionnaires that were fully completed among the 7370 surveys were taken into consideration. The statistical analysis was carried out using the SPSS software package.

RESULTS

The number of children found to have urinary incontinence was 215 (3.1%). It was seen that 33 children had urinary incontinence only in the daytime, 61 children experienced it both at night and during the day and 121 children at night. It was observed that 56% of the children suffering from urinary incontinence had not applied to any health facility for treatment prior to the study. It was found that among the risk factors for urinary incontinence were young age, late start of toilet training and presence of a family history of urinary incontinence.

CONCLUSIONS

Children with urinary incontinence and their families need medical information and support to reach the root of the problem and seek solutions. Accompanying pathologies in detected cases can be determined in the early period by means of school screenings, and medical evaluation and support can prevent adverse effects on children's psychosocial and personality development.

Effect of education given to children with enuresis on quality of life

INTRODUCTION

The quality of life of children diagnosed with enuresis is affected negatively compared with that of healthy children.

OBJECTIVES

This study aimed to evaluate the effect of the education program given within the framework of nursing activities on the quality of life of children diagnosed with enuresis.

STUDY DESIGN

The study was conducted on 60 children aged 7-12 years who applied to the urology clinic of a hospital in Turkey and were diagnosed with enuresis. Data were collected using the Pediatric Incontinence Questionnaire (PINQ). Children who met the study criteria were divided into two groups, control and experimental, using the random draw method. Participants in the experimental group were educated by the researcher with using the Enuresis Education Booklet.

RESULTS

Of the 60 children, 43.3% were aged 7-8 years and 63.3% were male. At baseline, the children in the control group revealed a total mean PINQ score of 45.00 ± 11.52, and the total mean PINQ score was 45.80 ± 12.05 at 1 month. At baseline, the children in the experimental group revealed a total mean PINQ score of 47.00 ± 11.88, and the total mean PINQ score of was 32.404 ± 8.62 at 1 month. A measurement carried out in the education and control groups 1 month later showed a statistically significant difference in the total mean PINQ scores (P < 0.001).

CONCLUSION

Explaining the disease thoroughly to a child created a positive effect on the child's quality of life.

Does desmopressin withdrawal strategy affect relapse rates in monosymptomatic enuresis treatment?

Desmopressin plays a major role in the treatment of monosymptomatic enuresis but has the drawback of a high relapse rate after medical treatment. This study investigated the effect of the type of treatment termination on relapse in a large population of patients. A total of 1013 patients who were admitted with bedwetting to our paediatric urology clinic between October 2016 and April 2018 were evaluated retrospectively. Four hundred forty-seven monosymptomatic enuresis patients were treated with 120 μg/day oral desmopressin lyophilisate for 3 months, after which the treatment was terminated in one of two ways: immediate cessation of desmopressin (group 1; N = 209) and structured withdrawal (group 2; N = 238). In the structured withdrawal group, the patients continued to take desmopressin every other day for 15 days. All the patients were followed up 1 month after the drug was withdrawn, and the relapse rates were recorded. One month after cessation of treatment with oral desmopressin lyophilisate, the relapse rate in group 1 was 42.5% (89/209), and that in group 2 was 41.1% (98/238) (p > 0.05).Conclusion: This study, with the highest number of patients among reports in the literature, revealed that the methods used to terminate desmopressin treatment are not significantly different in monosymptomatic enuresis management. What is Known: • It is still unclear how to end the treatment in patients who are started desmopressin because of the complaint of monosymptomatic nocturnal enuresis. • Although there are papers in the literature suggesting that the drug should be discontinued gradually or by reducing the dose, there are also authors stating the opposite. What is New: • This study including vast amount of patients managed with desmopressin reveals that withdrawal strategy has no impact on relapse.

Current perspectives on the correlation of nocturnal enuresis with obstructive sleep apnea in children

BACKGROUND

Obstructive sleep apnea (OSA) and nocturnal enuresis (NE) are common clinical problems in children. OSA and NE are thought to be interrelated, but the exact pathophysiological mechanisms are not yet clear. This review aims to explain the possible pathogenesis of NE in children with OSA.

DATE SOURCES

We have retrieved all relevant original articles from Database that have been published so far, including the prevalence studies of NE and OSA in children, sleep characteristic studies that use polysomnography (PSG) to focus on children with NE, and studies on the relationship between OSA and NE.

RESULTS

Clinical studies have revealed that the risk of NE in children with OSA was increased compared with that of their healthy peers. This increased risk may be associated with sleep disorders, bladder instability, detrusor overactivity, nocturnal polyuria, endocrine and metabolic disorders, and inflammation.

CONCLUSIONS

Cardiopulmonary and renal reflex-induced neuroendocrine disorder may play an important role in the mechanism of NE in children with OSA, but this remains to be confirmed by animal studies. Other causes such as oxidative stress and inflammatory responses need to be further researched.

Family compliance with the use of alarm devices in the treatment of monosymptomatic nocturnal enuresis

OBJECTIVE

In the treatment of monosymptomatic nocturnal enuresis (MNE), enuretic alarm devices (EADs) are the first recommended treatment option. This study aimed to evaluate parental and child compliance with EAD treatment.

MATERIAL AND METHODS

Fifty patients for whom EAD therapy was recommended were included in this study. The mean age of the patients was 10.4 years (5-16). All the patients were nursery or school children. Patients who did not return for their follow-up visits were called by phone, and verbal information were gathered about the use and performance success of the device. We documented the patients who used, and did not use the EAD with their reasons.

RESULTS

Nineteen (36%) patients were able to use the EAD without any problems. Eight of the remaining 31 patients didn't return for control, and they could not be get in touch with, either. Of the 23 (46%) families whom we could get a contact, 4 families did not purchase EAD due to a decrease in the number of wet nights, 4 families due to compensatory payment, and 3 families due to reluctance of one of the parents. One family reported that they gave up the EAD treatment because of the disturbing loud volume of the device. Four families reported that their children refused to use the EAD. Four families said that they could not use the EAD regularly because the device frequently did not work properly. In this study, we could not keep in touch with 16% of the patients, and 46% of the patients stopped using or did not receive this therapy.

CONCLUSION

Although EAD has been the priorly recommended alternative with its relatively higher success, and lower recurrence rates, our study demonstrated that the compliance of families with this treatment is below the expected level.