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Functional daytime incontinence: definitions and epidemiology
1Department of Paediatric Surgery, East Hospital, Gothenburg, Sweden.
Insights
Childhood urinary incontinence affects 6% of children aged 5+, with day wetting common. Most cases are functional, linked to unstable bladders, not underlying disease.
Area of Science:
- Pediatrics
- Urology
- Public Health
Background:
- Childhood urinary incontinence is defined as urine leakage of at least 1 ml weekly in children aged 5+.
- Functional day wetting, often due to unstable bladders, is common and not caused by disease.
- Prevalence data from a large study of school entrants provides insights into childhood incontinence patterns.
Purpose of the Study:
- To determine the prevalence of different types of urinary incontinence in children.
- To identify patterns and associations of daytime and nighttime wetting in children.
- To explore potential links between bacteriuria and day wetting in pediatric populations.
Main Methods:
- Analysis of prevalence data from the Gothenburg study involving 35,567 school entrants.
- Categorization of incontinence into day wetting, bedwetting, and combined types.
- Examination of the association between bacteriuria and day wetting in relation to gender.
Main Results:
- 6% of children reported any urinary incontinence weekly; day wetting affected 3.1% of girls and 2.1% of boys.
- Urgency was reported by most children with day wetting (82% girls, 74% boys).
- A strong association between bacteriuria and day wetting was observed in girls, but not in boys.
Conclusions:
- Functional day wetting is prevalent in children and often linked to unstable bladder function.
- No organic causes were detected in the studied children, highlighting the functional nature of most incontinence.
- The relationship between bacteriuria and day wetting requires further investigation to establish causality.
Abstract:
The definition of childhood urinary incontinence, used here, is leakage of at least 1 ml of urine at least once a week in a child from 5 years of age. Functional day wetting is incontinence not caused by disease, injury or congenital malformation, and is almost always urge incontinence due to an unstable bladder. The following figures for prevalence are quoted from the Gothenburg study of 35567-year-old school entrants. Any kind of urinary incontinence at least once a week was reported by 6% of the children. Day wetting at least once a week was found in 3.1% of the girls and 2.1% of the boys. Most of the day wetting children also had urgency which was reported in 82% of the girls and 74% of the boys. Bedwetting at least once a week was reported by 2.9% of the girls and 3.8% of the boys. The bedwetting was monosymptomatic (no additional symptoms, no day wetting) in 39% of the girls and 59% of the boys with nocturnal enuresis. Combined daytime and night-time incontinence was reported by 17% of the children, while 22% wet only by day, and 61% only by night. None of the 3556 children had a previously undetected organic cause for their incontinence. There is a strong association between bacteriuria and day wetting in girls, but not in boys. We do not know whether the bacteria cause the disturbance of bladder function, or vice versa. The cause and effect may work in both directions.