History Of Enuresis Research Articles

Prevalence and relevant factors of nocturia and its impact on sleep quality in Chinese university students

The purpose of this study was to investigate the prevalence and relevant factors of nocturia and its impact on sleep quality in university students in Mainland China. A large-scale survey was conducted on 14,000 university students from 3 universities in Henan province, China by using an anonymous questionnaire. The questionnaire collected the information from the past six months. The relationships between the prevalence of nocturia and its relevant factors were evaluated. A total of 13,874 questionnaires were collected and 13,104 qualified for statistical analysis. A total of 659 students suffered from clinically relevant nocturia (CRN) (4.56% in male and 5.34% in female). Both univariate analysis and the logistic stepwise regression model showed that the prevalence of nocturia was significantly related to female, history of enuresis, ease of waking up, urgency, frequency and RUTI (P < 0.05). The sleep quality and the university entrance score of CRN group was significantly lower than that of control group (P < 0.05). Nocturia was common in Chinese university students and showed a negative impact on sleep and academic performance. Gender of female, history of enuresis, ease of waking up, urgency, frequency and RUTI were relevant factors for CRN.

Enuresis in young offenders - a study on prevalence and mental health comorbidity.

Enuresis is a common disorder in the school-age period, and is often associated with a variety of behavioral, psychological, and social problems. While early studies suggested an association between enuresis and delinquent behavior, there has been no recent research assessing the prevalence of enuresis and its comorbid psychopathology in young offenders. The aim of this study was to therefore assess the prevalence of enuresis and its associated psychiatric comorbidity in incarcerated young offenders. The prevalence of past and current enuresis and comorbid psychopathology was assessed using a semi-structured psychiatric interview and self-reports from 366 incarcerated male young offenders [age 14 to 19 years (mean age = 16.4)] from Northern Russia. Seventy-three (20.0%) adolescents reported a previous history of enuresis, and in addition almost 10% of the youth reported current enuresis symptoms. Delinquent youth with enuresis did not significantly differ from other youth in the prevalence of comorbid psychiatric diagnoses when assessed by a clinical diagnostic interview, but had significantly higher levels of self-reported mental health problems, and suicidal ideation and attempts. Problems with enuresis are common among delinquent youth and may be associated with increased mental health problems. Given the potentially increased risk for suicidal thoughts and behavior in young offenders with enuresis, comprehensive mental health screening of those who are detected with this condition should be considered in the juvenile justice system.

Association of Overweight and Obesity with Monosymptomatic Nocturnal Enuresis in 5-15 Years Old Children

Background: Monosymptomatic nocturnal enuresis (MNE) has increasingly been reported as a challenging issue for families and children due to its impact on the psychological aspects of children and on reducing their concentration at school the next day. Obesity might serve as a risk factor for voiding dysfunction in children. Our study aimed to evaluate the relationship between excess body mass index (BMI) in children and MNE. Methods and Results: This case-control study included 60 children diagnosed with MNE (the main group [MG]) and 60 children without MNE (the control group [CG]) aged 5-15 years. Proper matching between the two groups concerning age and sex was adopted. Age, weight, family history, and complete medical history were recorded for each participant. In the MG, 18(30%) children had excess BMI, and 42(70%) had normal BMI. In contrast, 9(15%) children in the CG had excess BMI, and 51(85%) children had normal BMI, indicating a statistically significant association between increased BMI and MNE (P=0.049). The frequency of positive family history was significantly higher among the MG than the CG (P=0.0001). The findings of this study showed no significant relationship between gender and a family history of enuresis with excess BMI in children with MNE (P=0.679 and P=0.234, respectively). Conclusion: Obesity and overweight in children have an influence on the development of MNE.

Prevalence of Enuresis in Children, Adolescents, and Young Adults Diagnosed With Attention Deficit Hyperactivity Disorder.

Background Enuresis, or bedwetting, is a common condition affecting millions of children worldwide. This can be a source of distress for both children and their families. Children, adolescents, and young adults with attention deficit hyperactivity disorder (ADHD) are at risk of developing enuresis. They have difficulties with executive functioning, including impulse control and emotional regulation. These difficulties may contribute to the development of enuresis, as individuals may struggle to recognize the urge to use the bathroom or have difficulty controlling their bladder during sleep. Objective To assess the prevalence of enuresis in children, adolescents, and young adults with ADHD and determine whether the presence of other behavioral disorders such anxiety, depression, learning disabilities, and autism comorbid with ADHDis a risk factor for developing enuresis. Method A case-control studyincluded 213 children, adolescents, and young adults aged seven to 23 years, with 139 males and 74 females. A total of 161 participantswere diagnosed with ADHD. Data collection consisted of a semi-structured interview conducted with each participant or theirparents in person during their visit to Developmental Pediatric Clinics and Psychiatry Clinics. The questions were designed to collect data on the participant's ADHD diagnosis, enuresis history, other behavioral disorders, such as anxiety, depression, and learning difficulties, and any relevant medical or developmental history. The interview lasted approximately 30 minutes. Results Children, adolescents, and young adults with ADHD had a significantly higher prevalence of enuresis than the control group (13.6% vs. 0.9%, p = 0.01). Other behavioral disorders comorbid with ADHD did not pose a statistically significant risk for the development of enuresis (p = 0.36). Conclusions This study supports that children, adolescents, and young adults diagnosed with ADHD are more likely to have enuresis than those without ADHD. This finding is consistent with previous research and emphasizes the importance of a thorough evaluation and comprehensive treatment plan for individuals with ADHD.

The complex treatment paradigms for concomitant tethered cord and scoliosis: illustrative case.

Scoliosis associated with tethered cord syndrome is one of the most challenging spinal deformities to manage. Multiple surgical approaches have been developed, including traditional staged and concomitant procedures, spine-shortening osteotomies, and individual vertebral column resections. A 10-year-old female presented with congenital kyphoscoliosis with worsening curve progression, tethered spinal cord, and a history of enuresis. The scoliosis had progressed to a 26° coronal curve and 55° thoracolumbar kyphosis. Preoperative magnetic resonance imaging of the spine revealed a tethered cord between the levels of L3-4 and a large kyphotic deformity at L1. The patient underwent laminectomy, during which intraoperative motor signals were lost. A planned hemivertebrectomy at L1 was performed prior to an L4 laminectomy, untethering of the filum terminale, and posterior spinal fusion from T11 to L2. After surgery, the patient experienced transient lower-extremity weakness, with her neurological function improving from baseline over the next 2 months. Ultimately, the goal of this surgery was to halt the progressive decline in motor function, which was successfully achieved. Much remains to be learned about the treatment of this complicated disease, especially in the setting of concomitant scoliosis. This case serves to exemplify the complex treatment paradigms that exist when attempting to manage this clinical syndrome and that more remains to be learned.

Evaluation and management of enuresis in the general paediatric setting.

Assessing enuresis involves distinguishing monosymptomatic from non-monosymptomatic for this common paediatric problem, and identifying concomitant comorbidities. Addressing co-occurring factors concurrently ensures the best opportunity for a satisfactory outcome. Treatment begins with patient and family education on the natural history of enuresis and practical behavioural guidance. Evidence to support particular interventions is limited, and children and families should be involved when choosing appropriate therapy. Enuresis alarms and desmopressin are treatment options when more active intervention is desired. Clinical refinements and combined treatment modalities are emerging.

A CROSS SECTIONAL SURVEY TO KNOW THE PREVALENCE OF NOCTURNAL ENURESIS AND ASSOCIATED COMORBIDITIES IN CHILDREN AGED 5 TO 18 YEARS

Introduction: The present research was aimed to identify prevalence &amp; associated comorbidities of nocturnal enuresis in children.Methods: Present study was a cross sectional survey, conducted in two government schools. The school, administration was briefed about this disease, its adverse impact on child’s school performance. Data collected was related to age, gender, some disease characteristics, and associated comorbidities. Questionnaire used had contact number of the hospital, some general instructions to help these children like restricted liquid intake in evening hours, regular frequent urination &amp; maintenance of voiding diary. The permission to conduct the survey was granted by the schools. To maintain anonymity, to avoid embarrassment and to encourage maximum participation these were handed over to the class teachers who distributed these to the parents of all the students in next Parent teacher meeting. Children dropped these filled questionnaires in a box kept in common room.Results: Total 306 children were identified. Enuresis was commonest in age group 7-12 years. MNE was found in majority. Positive family history of enuresis &amp; poor quality of sleep was present in 50.3% &amp;32% children respectively. Functional constipation was found in 41.2% (126) &amp; UTI in 8.8% (27) children. Only 18.9% (58) children were taken to a health care facility for NE. Parental punitive practices reported were humiliation and physical punishment in 83% &amp;66.7% children.Conclusion: Nocturnal enuresis is a common under reported condition. Families and children are suffering instead of consulting a doctor parents’ resort to various punitive measures.

The Role of Hyposthenuria in Enuresis Among Paediatric Patients With Sickle Cell Disease.

Enuresis is common among children with sickle cell disease (SCD). Many risk factors have been postulated, but its relation to hyposthenuria is debatable. This study aimed to determine the prevalence of enuresis in children with SCD in Basrah, Iraq, and to examine its relation with hyposthenuria. A cross-sectional epidemiological study was performed on children with SCD who met the inclusion criteria at the Basrah Center for Hereditary Blood Diseases from December 2020 to May 2021. A questionnaire was used to collect relevant data. Blood samples were tested for haemoglobin genotype, certain blood indices and serum haemoglobin. Urine was tested for albumin and creatinine, and the specific gravity was measured using urine dipsticks. The relationships between enuresis and various sociodemographic and clinical variables were assessed. Binary logistic regression analysis was done to examine the independent risk factors of enuresis. A total of 161 out of 200 eligible children were included in this study (response rate: 80.5%). The majority of participants (60.9%) were males. The mean age of the participants was 10.9 ± 2.9 years. Enuresis was reported in 50 (31.1%) patients. The independent risk factors for enuresis included family history of enuresis (adjusted odds ratio [OR] = 5.94, 95% confidence interval [CI]: 2.54-13.89; P <0.001), hyposthenuria (OR = 3.76, 95% CI: 1.25-11.30; P = 0.018) and sleep disorders (OR = 2.90, 95% CI: 1.19-7.06; P = 0.019. Enuresis is common among children with SCD in Basrah, Iraq. Hyposthenuria was significantly associated with enuresis. Family history of enuresis and sleep disorders were also found to be significantly related to enuresis.

Socio Demographic Profiles of Enuresis among Primary School Children

Enuresis is defined in many different ways, but the common thread to all involves a lack of bladder control after 5 years of age, an age when most children would be expected to have achieved bladder control. Nocturnal enuresis is best regarded as a condition with different etiologies. Many aetiological theories have been proposed, with the cause of nocturnal enuresis now regarded as heterogeneous. This was a cross-sectional, descriptive study of primary school children aged between 6-12 years. The study was conducted in Borno State in the northeastern part of Nigeria, West Africa. The sample size is 560, with 260(52.1%) males and 239 (47.9%) females. The ages of the respondents ranged from 6 to 12 years, with a mean age of 9.47 years and a Standard Deviation (SD) of ±1.85. Nine variables, namely age, gender, home environment, maternal education/occupation, paternal education/occupation, family size, and family history of enuresis among siblings at 95% CI were considered. The variables that have a significant relationship with enuresis when the chi 2 test was used were further subjected to logistic regression analysis. The children’s sex, age group, family history, fathers’ education, and occupation were found to have statistical significance in predicting bedwetting among children. Health educators and primary care health staff should obtain detailed history not to miss patients with enuresis, and parents should be informed about the psychological effects of Enuresis and to seek appropriate treatment for their children.

Primary and Secondary Enuresis in Children Presenting At Pediatric Outpatient Department of Combined Military Hospital Malir Cantt Karachi

Objective: To determine the frequency of primary and secondary enuresis in the children presenting at outpatient department of Tertiary Care Hospital.&#x0D; Study Design: A cross sectional study.&#x0D; Place and Duration of Study: Outpatient Department of Combined Military Hospital Malir, Karachi, from Feb to July 2019.&#x0D; Methodology: A total of 1200 children with age range of 5-12 years were included in the study. Children presenting with severe acute illness or those with non-willing caregivers were excluded from the study.&#x0D; Result: Out of the total 1200 study participants, 167 (13.9%) children gave the history of enuresis. There were 109 (65.6%) boys and 58 (34.4%) girls. The children with primary enuresis were 141 (84.3%) while 26 (15.62%) children had secondary enuresis. About 31 (18.7%) children had daytime enuresis, 115 (68.5%) had night-time and 21 (12.5%) children had both day and night time bed wetting. About 57 (34.37%) children previously got the treatment for enuresis which included fluid restriction in 21 (12.5%) and desmopressin in 36 (21.87%). Out of them 52 (91.2%) children showed complete response while 5 (8.77%) showed incomplete response.&#x0D; Conclusion: Our study found that enuresis is more frequent among boys. Primary enuresis is more common than secondary enuresis and nocturnal enuresis is more common than diurnal enuresis.

Detská enuréza ako rizikový faktor dysfunkcie močového mechúra v dospelosti

Objective: To verify the relationship between enuresis in childhood and the type of urinary incontinence in adults, taking into account gender and age. Materials and methods: This retrospective cohort study used a database containing medical records of patients who had difficulty urinating and underwent urodynamic studies between 2010 and 2020 at the Vienna Private Clinic in Vienna. A total of 561 patient medical records were analyzed. A multinomial logistic regression model was modified for the type of UI (urinary incontinence). Statistical version 9.1.3 (SAS Institute, Inc., Cary, NC, 2016–2018) was used for data analysis. Results: Of the 561 patient records, 485 (88.5%) were women and 76 (11.5%) were men, with a mean age of 54 years (SD = 13.2). Patients with urge urinary incontinence (UUI) patients with stress urinary incontinence (SUI) and related variables were the presence of enuresis in childhood (OR = 2.37, IC: 1.43-3.92) and age&gt; 50 years (OR = 2.64). CI: 1.68 - 4.15). The presence of enuresis (OR = 1.77, CI: 1.15–2.73) and age over 50 (OR = 1.71, CI: 1) were also associated when comparing patients with mixed urinary incontinence (MUI) and SUI. There was no gender difference for both categories of urinary incontinence. Conclusion: Individuals with MUI and UUI in adulthood were more likely to have a history of enuresis in childhood than those who suffered from SUI.

Enuresis: clinical evolution of patients attended at specialized unit of paediatric urology.

To analyse the clinical evolution, the therapeutic strategies and the characteristics of the patients presenting enuresis attended at our outpatient clinic. Retrospective study of patients <14 years old(yo) diagnosed of enuresis attended at our outpatient clinic (2011-2019) and completed their follow-up (remission or aged 15). Urotherapy was offered to all patients as initial management. The therapeutic strategies were classified as: first line (desmopressin or clock alarm), second line (desmo-pressin+alarm) and third line(anticholinergics). The remission rate during follow-up, the number of consultations needed until remission and the treatments used were calculated. Statistical tests used:Kaplan-Meier, actuarial survival. Multivariate analysis:Cox regression.Statistical significance:p<0.05. Data were collected from 125 patients (mean age: 8.6±2.45yo). Family history of enuresis was present in 38.9%. The mean follow-up was 2.37±1.55yo and the average number of consultations was 7.54±5.06. The remission rate (RE) was 84%(n=105), with a median remission interval:2.66 years (2.34-2.991[95%CI]). The average number of treatments required for remission was 2.74±1.27. RE with urotherapy alone was 20%(n=25); RE with first line:19.3%(n=17) and second line:16.7(n=11). In the remaining patients, a RE of 78.18%(n=43) was achieved by adding an anticholinergic. Patients aged > 8.7 years at the beginning of the follow-up required less time to achieve remission (p=.025). These patients had a higher RE (hazard ratio 1.15 (1.05-1.25))(p=.004). No other variables were significant. Staged therapeutic strategies are necessary to achieve remission. Only 25% remitted with urotherapy as single treatment. RE are higher when patients are >8.7 yo once they initiate their follow up.

Epidemiology of Enuresis among Children in Diyala Governorate

Background: Nocturnal enuresis, is intermittent involuntary voiding in a child aged five years or more. One time a month for three months is required for the diagnosis. It is a common problem in children. It is the cause of stress for them and for their families. Enuresis can be classified into two types to understand its causes and treatment. These types are primary and secondary enuresis, monosymptomatic and polysymptomatic. Primary enuresis always associated with a familial history of delayed control of the urinary bladder. Secondary enuresis may cause by urinary tract or neurogenic causes like the spinal cord and urinary tract infection. Most of the cases were of the primary type. Objective: To evaluate the associated factor of nocturnal enuresis, study the various types of nocturnal enuresis, and evaluate the associated factors that affect the types of nocturnal enuresis. Patients and Methods: A cross-sectional study conducted in outpatient clinic of Albatool hospital in Diyala province, Iraq, 150 children was eligible in the study, which started from 1st Febreuary to 30th June 2020. Collection of the data was done by interview parents’ or the children's caregiver by a questionnaire that was used before for study enuresis. Analysis was carried out using statistical package for social sciences SPSS version 24. Results: The present study included 150 patients with enuresis, their mean age was 7.51±1.34 years (range:= 5-10 years), there were (59.3%) males and (40.7%) females. Most of the patients (61.3%) had 2-3 sibling, second in their birth order (52%), reside in the urban area (56%), a majority of the mothers 38% had primary school as their highest educational attainment, a majority of the fathers (32.7%) had secondary school as their highest educational attainment, most of the mothers 62.7% were housewives and 57.3% of fathers were employees. Regarding clinical features of the patients, 32% had a family history of enuresis, 52% had a history of fluid consumption other than water, 7.3% had a history of punishment, 8% had history of constipation, 27.3% had a history of emotional stress, 5.3% had a history of DM, 30.7% had a history of drug intake, 61.3% reveal UTI in their urinalysis, 78% reveal abnormal US findings. Secondary enuresis was found in 65.3% of the patients, while primary enuresis found in 34.7% of the patients, 7.3% of the patients complaining of diurnal enuresis. All studied factors not significantly associated with types of enuresis except constipation was found more in patients with secondary enuresis 91.7%. Conclusion: According to the previous study many risk factors were associated with nocturnal enuresis, in the current study these risk factors, except constipation which was associated with secondary enuresis, were not associated with nocturnal enuresis.

MO048PATHOGENIC VARIANTS IN CHLORIDE VOLTAGE-GATED CHANNEL 5 (CLCN5), ASSOCIATED WITH DENT DISEASE TYPE 1, SHOULD BE CONSIDERED IN END-STAGE KIDNEY DISEASE OF UNKNOWN AETIOLOGY

Abstract Background and Aims Hemizygous variants in chloride voltage-gated channel 5 (CLCN5) on chromosome Xp11.22 cause Dent disease type 1, characterised by low-molecular-weight proteinuria, hypercalciuria, nephrocalcinosis, nephrolithiasis, and progressive renal failure. We describe a truncating pathogenic variant in two brothers presenting with end-stage kidney disease (ESKD) and no evidence of nephrolithiasis or nephrocalcinosis. Method Two white British brothers presented to a different regional centre over 20 years ago with ESKD of unknown aetiology. The UK 100,000 Genomes Project provided a unique opportunity to make a molecular diagnosis using whole-genome sequencing linked to clinical records. Results The older brother presented with ESKD aged 23 with bilateral small kidneys and no evidence of nephrolithiasis or nephrocalcinosis on ultrasound. He had various musculoskeletal pains, 'cutaneous ectopic calcification' and secondary hyperparathyroidism, all of which improved post parathyroidectomy. Investigation of his 17-year-old brother for consideration of kidney transplant donation revealed progressive chronic kidney disease (CKD), microscopic haematuria, proteinuria (3g/24hours) and hypokalaemia. There was no nephrocalcinosis or renal calculi on ultrasound or cystoscopy. Renal biopsy showed tubulointerstitial changes with patchy fibrosis and marked chronic inflammatory cell infiltrates. He had a history of enuresis, polydipsia, delayed bone age and general developmental delay. ESKD by the age of 22 was complicated by hypertension and hyperparathyroidism requiring parathyroidectomy. Right knee pain with 'unusual osteochondral abnormality' on MRI resulted in a supracondylar femoral osteotomy. Early serum and urine biochemistry results were not available. A hemizygous nonsense variant p.Arg417Ter in CLCN5 was identified by whole-genome sequencing via the 100,000 Genomes Project. Sanger sequencing at the Wessex Regional Genetics Laboratory confirmed this. This variant was predicted to be protein-truncating, was absent in the genome aggregation database (gnomAD) and equivalent to a variant associated with Dent disease in other patients therefore classified as a class 5 pathogenic variant according to ACMG guidelines. Three male children with Dent disease have previously been reported with the pathogenic variant p.Arg347Ter. A seven and a twelve year old from two different families in Japan had microscopic haematuria, proteinuria, elevated β2-microglobulin and normal renal function. The twelve-year-old had mild hypercalciuria, but neither had a history of nephrolithiasis or nephrocalcinosis. A four-year-old Turkish boy manifested hypophosphataemia, nephrolithiasis and nephrocalcinosis. Unusually for Dent disease, he also had hypokalaemic hypochloraemic metabolic alkalosis and hyper-reninaemic hyperaldosteronism more characteristic of Bartter syndrome, but with elevated β2-microglobulin more typical of Dent disease. None of these cases had CKD but were all reported at a very young age. Conclusion Approximately 15% of patients with ESKD in Europe have an unknown aetiology. Dent disease has a variable phenotype and screening of patients for low molecular weight proteinuria such as β2-microglobulin is not routinely performed. Dent disease type 1 should be considered in patients presenting with unexplained renal failure even without typical clinical features.

Respiratory sleep disorders, nasal obstruction and enuresis in children with non-syndromic Pierre Robin sequence

IntroductionObstructive sleep apnea is highly prevalent in non-syndromic Pierre Robin sequence patients. Studies have found a probable relationship between obstructive sleep apnea and nasal obstruction and between obstructive sleep apnea and enuresis. Assessment of the relationship between these variables in non-syndromic Pierre Robin sequence patients is scarce. ObjectiveThe present study aims to evaluate the relationship between symptoms of obstructive sleep apnea, nasal obstruction and enuresis, determining the prevalence of symptoms suggestive of these conditions, in schoolchildren with non-syndromic Pierre Robin sequence, and describe the prevalence of excessive daytime sleepiness habitual snoring and voiding dysfunction symptoms associated with enuresis. MethodsThis was a prospective analytical cross-sectional study developed at a reference center. Anthropometric measurements and a structured clinical interview were carried out in a sample of 48 patients. The instruments “sleep disorders scale in children” “nasal congestion index questionnaire” (CQ-5), and the “voiding dysfunction symptom score questionnaire” were used. Statistical analysis was performed for p < 0.05. ResultsPositive “sleep disorders scale in children” scores for obstructive sleep apnea and CQ-5 for nasal obstruction were observed in 38.78% and 16.33%, respectively. Enuresis was reported in 16.33% of children, being characterized as primary in 71.43% and polysymptomatic in 55.55%; according to the “voiding dysfunction symptom score questionnaire”. There was a significant relationship between nasal obstruction and obstructive sleep apnea symptoms (p < 0.05), but no significance was found between obstructive sleep apnea symptoms and enuresis, and between nasal obstruction and enuresis. The prevalence of excessive daytime sleepiness was 12.24% and of habitual snoring, 48.98%. A family history of enuresis, younger age in years and a positive “voiding dysfunction symptom score questionnaire” score were associated with a higher prevalence of enuresis (p < 0.05). ConclusionChildren with non-syndromic Pierre Robin sequence are at high risk for obstructive sleep apnea symptoms and habitual snoring, with a correlation being observed between nasal obstruction and obstructive sleep apnea symptoms. In addition, the study showed that non-syndromic Pierre Robin sequence, obstructive sleep apnea and nasal obstruction symptoms were not risk factors for enuresis in these patients.

Assessment of Children with Primary Monosymptomatic Enuresis in Terms of Ambulatory Blood Pressure Changes

Objective: To evaluate the relationship between blood pressure changes monitored by 24-hour blood pressure measurements and urinary incontinence in children with enuresis. Method: The patients aged 5-18 years who received (patient group), and did not receive (control group) the diagnosis of primary monosymptomatic enuresis, and applied between January 01, 2017 and June 1, 2017, to the outpatient clinics of Izmir Tepecik Training and Research Hospital Department of Pediatric Nephrology and Pediatrics constituted the study group. Demographic data, height, body weight, body mass index, family history of chronic illness, and enuresis, drug use, laboratory test results (blood biochemistry and whole blood count) and ambulatory blood pressure monitoring (ABPM) measurements were compared between groups. Results: Thirty-five (62.5%, Group 1) patients and 21 (37.5%, Group 2) control subjects were included in the study. Demographic properties of the patients were not remarkable. Family history of enuresis was detected in statistically significantly greater number of patients (p=0.001). Any statistically significant difference was not noted when ABPM data of both groups were compared. Conclusion: Discrepancies in the results of various studies concerning the autonomic system changes in enuretic patients, their reflections on blood pressures, and 24-hour blood pressure profiles, in addition to controversial views of the authors about relationship between decreasing urine output and BP depression have necessitated conduction of further studies with larger group of patients.

Medical history of nocturnal enuresis during school age is an independent risk factor for nocturia in adults: The Nagahama study.

To evaluate the relationship between nocturia and medical history of nocturnal enuresis: two conditions where diurnal urination rhythm is disturbed. The Nagahama study is a longitudinal population-based health survey involving people aged 30-75 years in Nagahama city, Japan. Our analysis included 5,402 participants who completed enuresis and International Prostate Symptom Score questionnaires. Associations between nocturnal enuresis and nocturia were evaluated cross-sectionally and longitudinally with three models: (1) univariate analysis; (2) adjusted for basic characteristics (e.g., age, sex, body mass index, activity, alcohol, and smoking); and (3) adjusted for basic and clinical variables (e.g., hyperglycemia, hyperlipidemia, hypertension, renal insufficiency, insomnia, obstructive sleep apnea, and mental health). In total, 1,613 participants (29.9%) had a medical history of enuresis. The mean night-time frequency was 0.73 at baseline and 0.85 at the 5-year follow-up. The cross-sectional analysis showed participants with a medical history of enuresis had night-time frequency more often than those without this history (0.84 vs. 0.68, p < .0001). Significant differences were observed in Models 2 (p < .0001) and 3 (p < .0001). The longitudinal analysis showed nocturia progression was significantly related to a history of enuresis, with odds ratios of 1.32 (p < .0001) in Model 1, 1.21 (p < .01) in Model 2, and 1.22 (p < .01) in Model 3. Medical history of enuresis during school age was significantly related to nocturia in adulthood in the cross-sectional analysis, and to progression to nocturia in the longitudinal analysis. These two conditions may possess a common causative association.

Application of Machine Learning Techniques for Enuresis Prediction in Children.

As a subset of artificial intelligence, machine learning techniques (MLTs) may evaluate very large and raw datasets. In this study, the aim is to establish a model by MLT for the prediction of enuresis in children. The study included 8,071 elementary school students. A total of 704 children had enuresis. For analysis of data with MLT, another group including 704 nonenuretic children was structured with stratified sampling. Out of 34 independent variables, 14 with high feature values significantly affecting enuresis were selected. A model of estimation was created by training the data. Fourteen independent variables in order of feature importance value were starting age of toilet training, having urinary urgency, holding maneuvers to prevent voiding, frequency of defecation, history of enuresis in mother and father, having child's own room, parent's education level, history of enuresis in siblings, consanguineous marriage, incomplete bladder emptying, frequent voiding, gender, history of urinary tract infection, and surgery in the past. The best MLT algorithm for the prediction of enuresis was determined as logistic regression algorithm. The total accuracy rate of the model in prediction was 81.3%. MLT might provide a faster and easier evaluation process for studies on enuresis with a large dataset. The model in this study may suggest that selected variables with high feature values could be preferred with priority in any screening studies for enuresis. MLT may prevent clinical errors due to human cognitive biases and may help the physicians to be proactive in diagnosis and treatment of enuresis.

Nocturnal enuresis among children in Morogoro region in Tanzania: A cross-sectional survey

Background: Enuresis is common childhood disorders which affecting quality of life of children and causing significant psychosocial disturbances to children and their families. This condition has been widely reported globally with increasing data from sub-Saharan African region. In Tanzania there is no reports on its magnitude and therefore this study was carried out with the aim of determine the prevalence of this condition among children in Tanzania.Methods: This was a community based cross-sectional study conducted among children aged between 5 and 14 years recruited from 12 streets in Morogoro Municipality in Tanzania. Standardized Swahili questionnaire was used to collect data including socio-demographic details of parents, children and presence of enuresis. Socio-demographic data included age of the child, sex, level of education of the parents, education of the child, presence of bed wetting, history of enuresis in the family.Results: Five hundred and ten children were recruited into this study out of which 271 (53.1%) were females and mean age of study participants was 9±2.8 years. Enuresis was noted in 19% (97/510) of children, 68% (66/97) and 32% (31/97) had primary and secondary enuresis respectively. Significantly higher prevalence rates of enuresis were noted for children aged below 8 years 26.4% (43/162) and those with family history of enuresis 47% (18/38) with p values of 0.01 and &lt; 0.001 respectively. Forty-one (42.3%) out of 97 respondents whose children had enuresis reported to have punished their children and only 21.4% (20/97) reported to have sought treatment for their children.Conclusions: Enuresis is common among children in Tanzania particularly those with positive family history. Punishment to children with enuresis was noted in this study and only one in five parents/guardians sought treatment for their affected children. Therefore, there is a need for initiatives for raising community awareness about enuresis in Tanzania&#x0D; Key words: Enuresis in children, prevalence of enuresis in Tanzania, factors affecting enuresis in children.

Effectiveness of adenotonsillectomy in resolution of enuresis in children with sleep-disordered breathing: a hospital based prospective cohort study in Dar es Salaam, Tanzania

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Adenotonsillar hypertrophy remains to be the commonest causes of sleep disordered breathing in paediatric patients and has been implicated as a cause of primary and secondary enuresis. The aim of this study was to determine the effectiveness of adenotonsillectomy in resolution of enuresis in children with sleep-disordered breathing.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A hospital based prospective cohort study was conducted at Ekenywa Specialised Hospital in Dar es Salaam, from May 2018 to February 2019. Two hundred children aged 3 to 15 years with obstructive adenotonsillar hypertrophy who were admitted ready to undergo adenotonsillectomy were evaluated. Upon such evaluation, the primary outcome was the number of bedwetting incidents (nocturnal enuresis) post-operatively compared with pre-operative incidents. Patients were kept under follow-up for 3 months. Data were collected using structured questionnaires regarding number of bedwetting incidents, type of enuresis (primary or secondary) and family history of enuresis. Data was analyzed using SPSS version 21 and p-values &amp;lt;0.05 were considered to be statistically significant. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Of 200 children admitted for adenotonsillectomy, 80 (40%) had a positive history of preoperative enuresis, including 35 (43.8%) girls and 45 (56.2%) boys. All parents for the children consented to participate in the study. Three months after adenotonsillectomy, enuresis had resolved completely in 50 (62.5%) children and had shown relative improvement in 25 (31.3%) children. Enuresis had not improved in the remaining 5 (6.3%) children (p&amp;lt;0.05).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Findings from this study indicates that adenotonsillectomy can improve nocturnal enuresis and day-time incontinence in the majority of children with adenotonsillar hypertrophy.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;