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Published on: August 14, 2019
Prevalence of urinary incontinence and other lower urinary tract symptoms in children in the Netherlands
J M Linde1, R J M Nijman2, M Trzpis3
1Department of Urology, Division of Pediatric Urology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Surgery, Anorectal Physiology Laboratory, University of Groningen, University Medical Center Groningen, the Netherlands.
Insights
Urinary incontinence (UI) affects over 20% of Dutch children, even those considered healthy. Associated symptoms like straining and intermittency are common risk factors for UI in children.
Area of Science:
- Pediatric Urology
- Child Health Research
- Epidemiology of Lower Urinary Tract Symptoms
Background:
- Urinary incontinence (UI) is defined as involuntary urine leakage, impacting children's quality of life.
- Prevalence rates of UI and lower urinary tract symptoms (LUTSs) in Dutch children are not well-established.
- Existing research shows global variations in UI prevalence among pediatric populations.
Purpose of the Study:
- To determine the prevalence of urinary incontinence (UI) and other lower urinary tract symptoms (LUTSs) in Dutch children.
- To identify potential risk factors associated with UI in this population.
- To provide updated epidemiological data on pediatric UI in the Netherlands.
Main Methods:
- A cross-sectional study involving 240 children aged 8–17 years.
- Utilized the Groningen Pediatric Defecation and Fecal Continence Questionnaire to assess UI and LUTSs over the past six months.
- Defined UI according to the International Children's Continence Society (ICCS) criteria.
Main Results:
- The prevalence of UI episodes was 21.7% in the total study group.
- Girls (30.1%) had a significantly higher UI prevalence than boys (14.2%).
- Stress UI was the most common type (8.8%), and UI prevalence was 20.9% in healthy children. Intermittency (18.3%) and straining (15%) were frequent LUTSs, significantly associated with UI.
Conclusions:
- Urinary incontinence and other LUTSs are prevalent in Dutch children, including a significant proportion of healthy children.
- Symptoms like intermittency, straining, nocturia, and fecal incontinence are associated with UI.
- Healthcare providers should be aware of these common conditions and associated risk factors in pediatric patients.
Introduction:
The International Children's Continence Society (ICCS) defines urinary incontinence (UI) as 'involuntary leakage of urine' [1], a condition that can have a negative impact on a child's life. Although UI is common among children, the reported prevalences worldwide vary. Regarding children in the Netherlands, only a few studies report on the prevalence of UI and other lower urinary tract symptoms (LUTSs).
Objective:
The aim was to investigate the prevalence of episodes of UI and other LUTSs along with associated 'risk factors' in children in the Netherlands.
Study Design:
In a cross-sectional study, 240 children (8- to 17-year-olds) were included, who completed the Groningen Pediatric Defecation and Fecal Continence Questionnaire. UI was defined in accordance with the ICCS's definition of involuntary leakage of urine. To define a timeframe of episodes of UI, the situation during the past 6 months was specifically asked. The other LUTSs included were intermittency, straining, urinary tract infections, nocturia, and frequency.
Results:
The prevalence of episodes of UI in the total group was 21.7%. Girls experienced UI significantly more often than boys (30.1% versus 14.2%, P = 0.003). Prevalence did not differ between the 8- to 12-year-olds and the 13- to 17-year-olds. The most prevalent form of UI was stress UI (8.8%). After excluding six children with a medical history that could influence bladder function, UI in 20.9% of the remaining 'healthy' children was found. Intermittency was experienced by 18.3% of the children, and 15% strained during micturition. Univariate analysis showed that the presence of straining, intermittency, nocturia, or fecal incontinence was significantly associated with UI.
Discussion:
Of the children studied, episodes of UI occurred in 21.7%, and the condition did not decrease with age. It was found that UI is not limited to 'sick' children because it occurred in 20.9% of the 'healthy' subgroup. Although children with urge UI in daily practice were mainly seen, in this study, it was found that on average, stress UI was the most common form of UI among Dutch children. The prevalence of other LUTSs was also high, with intermittency and straining as the most frequent symptoms (18.3% and 15.0%, respectively). Intermittency and straining are significantly associated with UI, as are nightly nocturia and fecal incontinence.
Conclusion:
Episodes of UI and other LUTSs are common conditions among children in the Netherlands, even in the 'healthy' group. It is important that medical practitioners are aware of these phenomena, and they should be alert to the associated symptoms as they may be considered as 'risk factors'.
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