Related Experiment Videos
[Development of bladder capacity, nocturnal urinary volume and urinary behavior in nonenuretic and enuretic children]
A Kawauchi1, H Watanabe, S Nakagawa
1Department of Urology, Kyoto Prefectural University of Medicine.
Insights
Bladder capacity in children doesn't appear to be the primary cause of enuresis (bedwetting). Nocturnal polyuria is also unlikely to be a cause, suggesting treatment for enuresis should begin after age 8.
Area of Science:
- Pediatric urology
- Child development
- Sleep medicine
Context:
- Investigated bladder capacity, nocturnal urinary volume, and behavior in 1751 nonenuretic and 282 enuretic children.
- Study conducted in primary schools and kindergartens.
Purpose:
- To explore the relationship between bladder capacity, urinary output, and the incidence of enuresis in children.
- To determine potential primary causes of enuresis and optimal timing for intervention.
Summary:
- A significant linear correlation exists between age and bladder capacity/nocturnal urinary output in nonenuretic children.
- Enuretic children showed smaller bladder capacity below age 6 and larger capacity above age 7 compared to nonenuretics, refuting immaturity as a primary cause.
- Morning urinary output post-awakening is a more reliable indicator of maximum bladder capacity than daytime output.
- Nocturnal polyuria was observed in 10-15% of nonenuretic children, also unlikely as a primary cause of enuresis.
- Overall enuresis occurrence was 14%, with higher rates in males under 9. Spontaneous resolution averaged 7.3 years, suggesting treatment post-age 8.
Impact:
- Provides evidence against immature bladder capacity and nocturnal polyuria as primary causes of childhood enuresis.
- Suggests morning voided volume is a better clinical indicator for enuresis studies.
- Recommends initiating enuresis treatment after age 8, based on spontaneous resolution rates.
Abstract:
Bladder capacity, nocturnal urinary volume and nocturnal urinary behavior were investigated in 1751 nonenuretic and 282 enuretic children in two primary schools and four kindergartens. The results were as follows: 1. A statistically significant linear correlation was observed between the age and the bladder capacity in the morning and daytime, as well as nocturnal urinary output, in nonenuretic children. 2. The bladder capacity of enuretic children was smaller in the ages below 6 but larger in the ages over 7 than that of noneuretic children. It was not likely from this evidence that an immature bladder capacity was a primary cause of enuresis. 3. For the estimation of the maximum bladder capacity in the study of enuresis, urinary output in the morning immediately after awakening with sufficient urinary sensation was thought to be more reasonable than that in the daytime, because output in the morning was approximately 50% more than that of the daytime. 4. Ten to 15% of nonenuretic children showed nocturnal polyuria with nocturnal urination after complete awakening more than one time every week. It was also not likely from this evidence that polyuria was a primary cause of enuresis. 5. The overall occurrence rate of enuresis was 14%, higher in males up to the ages of 9, and almost equal in males and females after the ages of 10. 6. The average age for the spontaneous disappearance of enuresis was 7.3 y.o., therefore, adequate treatments for enuresis should be instituted after the age of 8.