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The assessment of constipation in monosymptomatic primary nocturnal enuresis
1Department of Urology, University of Mersin School of Medicine, Turkey. selcayan@mersin.edu.tr
Insights
Children with primary nocturnal enuresis (bedwetting) are significantly more likely to also experience constipation. Early assessment for constipation is recommended in children with bedwetting to ensure comprehensive care.
Area of Science:
- Pediatric Urology
- Gastroenterology
- Public Health
Background:
- Nocturnal enuresis and constipation are prevalent pediatric conditions.
- Understanding the relationship between these conditions is crucial for effective management.
Purpose of the Study:
- To determine the incidence of constipation in children with and without monosymptomatic primary nocturnal enuresis.
- To investigate the association between nocturnal enuresis and constipation in a pediatric population.
Main Methods:
- A survey of 5350 children (ages 5-19) identified 679 with primary nocturnal enuresis.
- A subset of 125 children with nocturnal enuresis underwent further evaluation, including abdominal ultrasound, serum creatinine tests, and plain abdominal films.
- Defecation habits were assessed via mail questionnaire.
Main Results:
- Constipation was diagnosed in 7.06% of children with nocturnal enuresis versus 1.45% of those without, a statistically significant difference (p=0.000).
- Plain abdominal films revealed fecal loading in 8 of 125 evaluated children, with 7 of these also having constipation.
- The sensitivity of plain film grading for detecting constipation was 87.5%.
Conclusions:
- A significant association exists between primary nocturnal enuresis and constipation.
- Pediatric patients presenting with primary nocturnal enuresis warrant a thorough evaluation for concurrent constipation.
Objectives:
Nocturnal enuresis and constipation are common pediatric problems. The aim of this study was to assess the incidence of constipation in children with or without monosymptomatic primary nocturnal enuresis.
Methods:
The study included 5350 children, ages 5-19 years, who were surveyed to detect the incidence of nocturnal enuresis. Of those surveyed, 679 (12.7%) had primary nocturnal enuresis. All children were questioned by mail with a standard form that addressed their micturition and defecation habits. The children those who had primary nocturnal enuresis were invited to the Pediatric Urology Section of the University Hospital. Of those 679 children, 125 kept that invitation. All 125 of those children underwent an abdominal ultrasound. Also, these children had serum creatinine levels drawn and plain abdominal films taken.
Results:
Constipation, defined as less than 3 bowel movements per week, was seen in 48 of 679 children with nocturnal enuresis (7.06%). Of those 4671 children without nocturnal enuresis, only 68 (1.45%) had constipation. The difference in constipation between the two groups was statistically significant (z = -9.251; p = 0.000). Of note, 10 of the 125 children (8%), evaluated at the hospital, had constipation. None of the children had an abnormal neurologic examination. Finally, faecal loading was detected on the plain films of 8 of the 125 children evaluated, 7 of who had constipation. The sensitivity of grading plain films for faecal loading to denote constipation in this population was 87.5%.
Conclusions:
Children with primary nocturnal enuresis should be thoroughly assessed for coexisting constipation.