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A population based study of 2,856 school-age children with urinary incontinence
Premala Sureshkumar1, Mike Jones, Robert Cumming
1Center for Kidney Research, NHMRC Center for Clinical Research Excellence, Children's Hospital at Westmead and School of Public Health, Concord Hospital, University of Sydney, Sydney, Australia. premalas@chw.edu.au
Insights
Daytime urinary incontinence affects 16.9% of school-aged children, with risk factors including nocturnal enuresis, female gender, and urinary tract infections. Interventions should address physiological and environmental factors.
Area of Science:
- Pediatric Urology
- Child Health Epidemiology
- Continence Disorders
Background:
- Daytime urinary incontinence (DUI) is a common yet heterogeneous condition in school-aged children.
- Understanding its spectrum and risk factors is crucial for effective management.
Purpose of the Study:
- To estimate the prevalence and spectrum of daytime urinary incontinence in school-aged children.
- To identify independent risk factors associated with DUI in this population.
Main Methods:
- A validated, parent-administered questionnaire was used to collect data from 2,856 randomly selected school children.
- Information gathered included demographic, prenatal, developmental, and bowel/urinary history.
- The frequency and amount of incontinence were recorded to assess the spectrum.
Main Results:
- 16.9% of children reported any DUI in the past six months, with varying severity.
- Key independent risk factors identified were nocturnal enuresis, female gender, social concerns, urinary tract infection (UTI), and encopresis.
- UTI was a significant risk factor for boys but not girls.
Conclusions:
- Daytime urinary incontinence in children is a common disorder with a heterogeneous presentation but shared causal pathways.
- Identified risk factors, including encopresis and nocturnal enuresis, highlight the need for interventions targeting physiological and environmental factors.
Purpose:
We estimated the spectrum and risk factors for daytime urinary incontinence in school-age children.
Materials And Methods:
A validated, reproducible, parent administered daytime incontinence questionnaire was distributed to randomly selected school children. The questionnaire elicited information on demographic factors, prenatal and developmental factors, and bowel and urinary history. The spectrum of daytime urinary incontinence was measured by recording the frequency and amount of incontinence.
Results:
Parents of 2,856 children (mean age 7.3 years) completed the questionnaire. Overall 16.9% reported any daytime urinary incontinence in the previous 6 months, with 64% of cases being very mild, 14.8% mild, 11.6% moderate and 9.6% severe. There was low agreement between frequency and amount of incontinence (weighted kappa 0.03) but risk factors were similar. Independent risk factors were nocturnal enuresis (OR 7.2, 95% CI 3.4 to 15.2), female gender (5.4, 2.6 to 11.1), social concerns (3.4, 1.4 to 8.3), urinary tract infection (5.6, 2.0 to 15.6) and encopresis (3.3, 1.4 to 7.7). Expressed as population attributable risk, 36% of moderate to severe daytime incontinence can be attributed to encopresis, nocturnal enuresis, social concerns, female gender or urinary tract infection. Urinary tract infection was a risk factor for boys but not for girls (interaction p <0.01).
Conclusions:
Daytime urinary incontinence in children is a common but heterogeneous disorder. Episodes may be frequent or major or both but appear to share the same causal pathway. Given the risk factors identified, interventions should target endogenous/physiological and environmental factors.
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