Factors Of Enuresis Research Articles

Clinical profile and risk factors of enuresis in children

Background: Enuresis is a common problem in children and its incidence is multifactorial in nature. The aim of this study is to assess the etiological risk-factors in enuresis in the study population and also to compare the risk factors in enuresis subgroups.Methods: A total of 51 patients with enuresis presenting to the department of paediatrics, Institute of Social Paediatrics, Govt. Stanley Hospital, Chennai were included in the study. All children were sub classified as primary/secondary and the primary enuretics were sub classified into monosymptomatic/non monosymptomatic depending on the symptoms. The data was analyzed and the results presented.Results: Enuresis was common in boys. Statistically significant difference in the incidence of disorder between primary and secondary enuretic children was seen in relation to presence of storage symptoms (p=0.04), cystitis (p=0.013) sleep disordered breathing (p=0.0001) and low-income status (p=0.04). No statistically significant difference between into monosymptomatic nocturnal enuresis (MNE) and non-monosymptomatic nocturnal enuresis (NMNE) children was observed in terms of gender, difficulty in arousal, specific gravity, spina bifida, low bladder capacity and family history (p>0.05).Conclusions: The findings of the study reported that risk factors related to the incidence is similar in both primary and secondary enuresis. MNE and NMNE have no differences in the presentation and probably represent the spectrum of a same disorder.

A Comparative Study of Anxiety Level of Enuretic and Non-Enuretic Children

Enuresis is more commonly known as bed-wetting. Enuresis is diagnosed when children repeatedly urinate in inappropriate places, such as clothing (during the day) or the bed (during the night). In most cases, the child’s urination problem is involuntary in nature, and is perceived by the child as an unavoidable loss of urinary control. This condition is most likely a symptom of psychological stress, although physiological causes, such as bladder infection, should not be ruled out. In general, the causes of bedwetting are related to anxiety, life stress, and possibly trauma, both inside and outside the home. Psychological factors such as a stressful life situation (death of a parent) or birth of a new sibling, disturbed family patterns, and delay toilet training, personality characteristics, parenting style, anxiety or presence of other emotional problems may predispose factors of enuresis. Many Children with enuresis experience significant distress or impairment in their social, academic, or everyday lives and the disorder can also drastically affect their families. The aim of the study is to find out the Anxiety level of Enuretic and Non-Enuretic Children.Test Anxiety Scale for Children (TASC) questionnaire made by A. kumar to determine anxiety level administered over 80 (Boys and girls) children of enuretic and non-enuretic. Result showed that there is significant difference in anxiety level of enuretic and non-enuretic children (p<.01).

The role of sleep and arousal in nocturnal enuresis

Aim: To review what is known about the role of sleep and arousal mechanisms in the pathogenesis of nocturnal enuresis. Methods: A review of the literature was carried out. Results: The sleep of enuretic children, although polysomnographically quite normal, is exceedingly “deep”; that is enuretic children have high arousal thresholds. Apart from some overlap between enuresis and the (other) classic parasomnias, the sleep of enuretic children is no more problematic than that of the general population. Recently, the exciting possibility has arisen that the low arousability of enuretic children may be linked to the autonomous nervous system and to disturbances in the upper pons. Conclusions: Enuresis is not just a nocturnal problem but a disorder of sleep. The high arousal threshold is one of three major pathogenetic factors in enuresis—nocturnal polyuria and detrusor hyperactivity being the other two.

Enuresis and encopresis in a south Indian population of children.

Though bladder and bowel control are important developmental milestones in all cultures, the prevalence of enuresis and encopresis has rarely been studied in developing countries despite there being factors in these countries that could affect it. This study reports the prevalence and associations of enuresis and encopresis in children in Kerala, India. The parents of 1403 randomly selected 8-12-year-old children were interviewed. The prevalence of enuresis and encopresis was ascertained using Rutter's A2 scale. Subsamples of children underwent psychiatric, physical and psychometric evaluations. Of the children, 18.6% had had an episode of enuresis in the past year and 4.3% in the past week. Four per cent had had an episode of encopresis in the past year. Enuresis was associated with parents' education, physical and psychiatric symptoms in the child, poor academic achievement and lax parental attitudes to toilet training. Encopresis was associated with male sex, physical and psychiatric symptoms, poor academic achievement, early separation and not having a toilet. The prevalence of enuresis compares with western countries, but encopresis is commoner. The associations of enuresis suggested a multifactorial model in which parental competence was prominent. This study de-emphasized the importance of neurodevelopmental factors in enuresis and encopresis in this age group.

Provoked Enuresis-like Episodes in Healthy Children 7 to 12 Years Old

Purpose We evaluated whether a water load before bedtime provoked enuresis episodes in healthy children with no previous enuresis. We also studied pelvic floor activity during an enuresis episode and the completeness of bladder emptying, attempted to identify a possible trigger mechanism for nocturnal enuresis, and investigated any age and sex differences regarding the frequency of provoked enuresis episodes. Materials and Methods We evaluated 55 healthy volunteers (22 girls and 33 boys) 7 to 12 years old who were dry from age 5 years and had no urological or other complaints. Subjects were admitted to the hospital for 4 consecutive nights. Night 1 was for adaptation without a water load. On nights 2 to 4, 25 ml./kg. body weight of water were given orally half an hour before bedtime. During the night pelvic floor activity was monitored, and the time and volume of enuresis and nocturia episodes were noted. Results In 17 subjects 28 enuresis-like episodes were provoked, generally comprising incomplete voidings with large residual volumes mostly in younger chilren and in boys. Enuresis and nocturia episodes were provoked at a volume specific for each individual without a relation to the bladder filling rate. Conclusions Our results support the hypotheses that nocturnal polyuria is an important pathogenetic factor in enuresis and that arousal failure can be provoked in nonenuretic subjects.

Constipation: a cause of enuresis

Chronic functional constipation was confirmed by history, rectal examination, and rectal manometric studies in 20 of 26 children with enuresis. Treatment of constipation resulted in resolution of the enuresis. Uninhibited bladder contractions, observed in enuretic constipated children, were also noted in children with constipation alone, suggesting that constipation is a commonly unrecognized etiologic factor in enuresis.

Constipation: A Commonly Unrecognized Cause of Enuresis

• Constipation was confirmed by history, rectal examination, and rectal manometric studies in 22 of 25 children with enuresis. Treatment of constipation resulted in resolution of enuresis. Uninhibited bladder contractions, observed in enuretic constipated children, were also noted in children with constipation alone, suggesting that constipation is a commonly unrecognized etiologic factor in enuresis. ( AJDC 1986;140:260-261)

Constipation a commonly unrecognized cause of enuresis.

Constipation was confirmed by history, rectal examination, and rectal manometric studies in 22 of 25 children with enuresis. Treatment of constipation resulted in resolution of enuresis. Uninhibited bladder contractions, observed in enuretic constipated children, were also noted in children with constipation alone, suggesting that constipation is a commonly unrecognized etiologic factor in enuresis.

Diurnal Anti-Diuretic-Hormone Levels in Enuretics

The diurnal antidiuretic hormone levels were studied in eleven enuretics and related to urine production and functional bladder capacity. A fluid deprivation test monitoring antidiuretic hormone levels was undertaken in four patients. The study suggests that the normal increase in nighttime antidiuretic hormone levels is absent in enuretics, who show a stable hormone level both day and night. Consequently the volume of night urine production approximates day urine production per hour. The functional bladder capacity was clearly exceeded at night in eight of eleven patients. The fluid deprivation test showed a normal response to fluid deprivation.In conclusion, the study adds further evidence that bladder capacity is a major factor in enuresis. Urine volumes that exceed bladder capacity at night may be caused by a lack of diurnal rhythmicity in antidiuretic hormone levels.

RELATIVE NOCTURNAL POLYURIA AS A FACTOR IN ENURESIS

RELATIVE NOCTURNAL POLYURIA AS A FACTOR IN ENURESIS

ENURESIS IN CHILDREN

Thirty of a total of ninety children, residents in the Norwegian Lutheran Home for Children, were studied. Fifteen of these were enuretic, and fifteen served as a control group. All of the children in the home about whom there were complaints of bed wetting were included, with the exception of two, aged 3 years. Nine boys and six girls comprised each group. They ranged in age from 5 to 14 years. The objectives of this study were: (1) to determine and evaluate causative factors of enuresis in each individual case, if possible; (2) to determine significant differences, if any, between the enuretic group and a nonenuretic group of children from the same home and (3) to determine the response of the enuretic children to a group method of treatment. INCIDENCE OF ENURESIS Of the fifteen enuretic children included in our study, eight were known to have had the condition before

A CLINICAL STUDY OF ENURESIS

A group of children suffering with enuresis was studied; 129 were boys and 123 girls. The observation covered a period of three years. The following factors to which enuresis is commonly ascribed were selected for study: Enlarged or diseased tonsils and adenoids. Eye strain. The male prepuce. A small meatus. Vaginitis. Pyelitis. Defective posture. Malnutrition. The neurotic constitution. The psychic factor and the role of discipline. Sex. CAUSATIVE FACTORS IN ENURESIS The Relation of Enlarged or Diseased Tonsils and Adenoids to Enuresis .—It was found that 116 of the children showed sufficient trouble with tonsils or adenoids to justify their classification as abnormal. In forty-nine of these, the tonsils and adenoids were removed for the purpose of curing the enuresis. This it seemed to do in one case. In one other case, the enuresis became considerably worse after the operation, and in the remaining forty-seven cases it did not seem