Prevalence of enuresis and its impact in quality of life of patients with sickle cell disease

ABSTRACT Introduction Evidence indicates an increase in the prevalence of enuresis in individuals with sickle cell disease. The present study aims to evaluate the prevalence and impact of enuresis on quality of life in individuals with sickle cell disease. Materials and Methods This cross-sectional study evaluated individuals with sickle cell disease followed at a reference clinic, using a questionnaire designed to evaluate the age of complete toilet training, the presence of enuresis and lower urinary tract, and the impact on quality of life of these individuals. Results Fifty children presenting SCD (52% females, mean age ten years) were included in the study. Of those, 34% (17/50) presented as HbSC, 56% with HbSS (28/50), 2% Sα-thalassemia (1/5) and 8% the type of SCD was not determined. The prevalence of enuresis was 42% (21/50), affecting 75% of subjects at five years and about 15% of adolescents at 15 years of age. Enuresis was classified as monosymptomatic in 33.3% (7/21) and nonmonosymptomatic in 66.6% (14/21) of the cases, being primary in all subjects. Nocturia was identified in 24% (12/50), urgency in 20% (10/50) and daytime incontinence 10% (5/50) of the individuals. Enuresis had a significant impact on the quality of life of 67% of the individuals. Conclusion Enuresis was highly prevalent among children with SCD, and continues to be prevalent throughout early adulthood, being more common in males. Primary nonmonosymptomatic enuresis was the most common type, and 2/3 of the study population had a low quality of life.

Enuresis de causa no orgánica en edades pediátricas / Non-organic enuresis in pediatric ages

Introducción: la enuresis se define como la emisión involuntaria de orina que ocurre generalmente en el niño mientras duerme en la noche, aunque también puede ocurrir durante el sueño diurno. Se considera patológico por encima de los 5 años de edad. Objetivo: describir aspectos clínicos epidemiológicos de la enuresis de causa no orgánica en la población infanto juvenil del Equipo Básico de Salud 15 del Policlínico Docente Marta Martínez Figuera. Métodos: investigación descriptiva, de corte transversal realizada durante el periodo de tiempo comprendido entre enero de 2010 hasta enero 2011, en el municipio de Güines, provincia Mayabeque. La muestra estuvo constituida por 38 niños y adolescentes que cumplieron con criterios de inclusión previamente establecidos. Resultados: predominó en este estudio la enuresis infantil de tipo primario, entre los 5-8 años de edad y con un tiempo de evolución del síntoma entre 1-4 años. No se encontró diferencias estadísticamente significativas con relación al sexo, así como se demostró pobre asociación entre el síntoma enurético y la presencia de enfermedades comórbidas. La gran mayoría de los niños estudiados habían recibido tratamiento para su control en el momento del estudio; así como se demostró una evolución no adecuada del síntoma enurético a pesar del tratamiento utilizado. Conclusiones: se demostró la presencia de enuresis de causa no orgánica en los niños estudiados. Se considero conveniente diseñar estudios de intervención dirigidos a reducir las afectaciones para la salud en niños con esta patología

Introduction: enuresis is defined as the involuntary release of urine that usually occurs in children while sleeping at night, but it can also occur during daytime sleep. It is considered pathological over 5 years of age.Objective: to describe the clinical and epidemiological aspects of non-organic enuresis in the child and adolescent population of the 15th Basic Health Team of Marta Martinez Figuera Teaching Polyclinic.Methods: a descriptive, transversal research conducted during the time period from January 2010 to January 2011, in Güines municipality, Mayabeque province. The sample consisted of 38 children and adolescents who met inclusion criteria previously established.Results: in this study predominated the infantile enuresis of the primary type, between 5-8 years of age and with an evolution of symptoms within 1-4 years. No statistically significant differences were found with regard to sex and it was shown poor association between the enuretic symptom and the presence of comorbid diseases. The vast majority of the children studied had received treatment for their control at the time of the study, and it was demonstrated an inadequate evolution of the enuretic symptom despite treatment used.Conclusions: it was demonstrated the presence of non-organic enuresis in the children studied. It was considered convenient to design intervention studies aimed at reducing the affectations to health in children with this pathology

Prevalence and associated factors of enuresis in turkish children

OBJECTIVE: Enuresis, which is frequently diagnosed amongst schoolchildren, is an important psychosocial problem for both parents and children. In the present study we aimed to determine the prevalence and associated factors of enuresis in Turkish children and to identify common methods for its management. MATERIALS AND METHODS: A cross sectional epidemiological study was performed among primary school children living in Ankara, Turkey. A self-administered questionnaire was prepared for this study and distributed to the parents of 1,500 schoolchildren whom aged 6-12 years. RESULTS: Of the 1,500 questionnaires distributed, 1,339 (89 percent) were completed. The overall prevalence of nocturnal and diurnal enuresis were 17.5 percent (n = 234) and 1.9 percent (n = 25), respectively. Although male gender, low age, history of enuresis among parents, low educational level of the parents, deep sleep, increased number of siblings, increased number of people sleeping in the child's room, history of enuresis among siblings, poor school performance and history of recurrent urinary tract infections (UTI) were significantly associated with enuresis, but not with severe enuresis. The percentage of children with enuresis seen by physician for treatment was 17.2 percent. The most preferred treatment option for enuresis was medications (59.5 percent), whereas alarm treatment was the least preferred (2.4 percent). CONCLUSIONS: Our results with enuresis prevalence and associated factors were comparable to other epidemiologic studies from various countries. Furthermore we demonstrated that families in Turkey do not pay sufficient attention to enuresis and most of enuretic children do not receive professional treatment.

Significance of recent onset nocturnal enuresis in adult men: a prospective study.

INTRODUCTION: Although literature on childhood nocturnal enuresis and its persistence into adulthood is abundant, recent onset nocturnal enuresis in adults is a poorly studied symptom. OBJECTIVE: To determine the significance of recent onset nocturnal enuresis in adult males in relation to lower urinary tract pathology, and its treatment. METHODS: All men with recent onset nocturnal enuresis attending a urology unit over a period of 12 months were evaluated prospectively. Their treatment and outcome were recorded. RESULTS: There were 30 patients (mean age 64 years). Ultrasonography revealed upper urinary tract dilatation in 22 patients. Another six patients had post-void residual urine volume over 500 mL without upper tract dilatation. Only two patients did not have ultrasonographic evidence of bladder outflow obstruction. Elevated blood urea was noted in 14 patients. Twenty patients underwent transurethral resection of the prostate (TURP) and one patient with balanitis xerotica obliterans had circumcision and meatotomy. Three patients were taught clean intermittent self catheterisation, and three patients preferred indwelling urethral catheters. One patient while awaiting TURP died of a myocardial infarction. Eight patients, who were treated with alpha-adrenergic antagonists initially, required further intervention later as the response to medical therapy was poor. CONCLUSIONS: Recent onset nocturnal enuresis in adult males is a symptom closely associated with significant lower urinary tract pathology requiring early urological intervention. Considering its impact on management it is reasonable to classify recent onset nocturnal enuresis as a lower urinary tract symptom in adult men and including it in symptom scores used to assess bladder outflow obstruction.

Enuresis funcional. Manejo psicomotor de los esfínteres vesicales / Functional enuresis

La enuresis es un problema cotidiano de salud en un número importante de niños mayores de 3 años de edad, aunque su frecuencia y prevalencia reales se desconozcan en nuestro país. Su importancia se incrementa debido a la gran vinculación que tiene con los padres de familia y, además, porque su manejo es aún tema de controversia. En la presente revisión bibliográfica se describen los principales aspectos clínicos de esta anomalía; se incluye un cuadro de facíl manejo sobre el criterio diagnóstico en la enuresis funcional, y se hace énfasis en la vigilancia que debe ejercer el médico cuando instituye tratamiento farmacológico. En especial, se destaca la trascendencia que ofrece educar al paciente y a sus padres o cuidadores, a través de instituir, a la brevedad posible, la práctica cotidiana del manejo de los esfínteres vesicales al aportador al niño cantidades generosas de líquidos durante el día. Insistiéndole en la necesidad imperiosa que existe en su caso, de que concientice las sensaciones de la necesidad de miccionar y la conveniencia de controlar los esfinteres mencionados

Analysis of psychiatric morbidity of outpatient children in Mitford Hospital, Dhaka.

The objective of this study was to describe the pattern of psychiatric morbidity among 97 child patients who, for the first time attended the psychiatric outpatient department of Sir Salimullah Medical College & Mitford Hospital, Dhaka, in the year 1994. Dissociative disorder (Hysteria) comprised the largest group (21.65%), followed by epilepsy (19.59%). Majority of the cases were within 7-10 years age group with mean age 9.74 (+/- 2.39) years. Male outnumbered female patients and 53.61% cases came from rural background. The findings of the study indicate the need for establishment of child psychiatric treatment centres in different parts of the country including rural areas.

Enuresis en pediatría / Enuresis in pediatrics

La enuresis es un problema frecuente en pediatría; su orgien es aún obscuro y su tratamiento se presta a controersias. Obedece generalmente a un retardo en la maduración neurológica del niño; sin embargo en muchos pacientes es posible reconocer un problema orgánico.

Estudio epidemiológico de las enfermedades neurológicas en Santiago Metropolitano, Chile / Epidemiological study of neurological diseases in Metropolitan Santiago, Chile

Se formó un equipo multidisciplinario con en el fin de determinar la prevalencia de las principales enfermedades neurológicas en Santiago, Chile. Se utilizó una muestra de 1.710 hogares encuestados a 7.195 personas. Se aplicó el protocolo elaborado por la OMS y describimos el método utilizado en detalle. La prevalencia de los desórdenes neurológicos fue de 102,4 por mil, distribuyéndose en un 62% en el sexo femenino. Los cuadros de mayor prevalencia fueron la cefalea (19,2 por mil), epilepsia (16,5 por mil) y migraña (14,9 por mil). En cuanto a los cuadros vasculares representan todos por AVC (5,9 por mil), TIA (2,9 por mil). En los relativos a la infancia y adolescencia destacan la convulsión febril con un 38,1 por mil, trastornos del aprendizaje con 20,6 por mil y trastornos del lenguaje con 5,8 por mil

Nocturnal enuresis in normal Jamaican children: implications for therapy

The prevalence of nocturnal enuresis has been investigated in 477 children (243 boys, 234 girls) attending government Basic Schools in Kingston, Jamaica. Enuresis, defined as wet at least 2 nights a week, occurred in 62%, 48%, 42%and 40%at 2, 3, 4 and 5 years of age, respectively. Enuresis, defined as wet at least one night a month, occurred in 68%, 58%, 53%and 52%, respectively. There was no significant difference between the sexes. Children with a family history of enuresis (first degree relatives wet beyound 8 years of age) were more likely to be enuretic than those with no family history, the difference reaching statistical significance for girls (<0.001) and for the sexes combined (p <0.001) but not for boys alone (p=0.06). The prevalence of nocturnal enuresis in Jamaican children is higher than reported for Black children elsewhere, which in turn is higher than in their White counterparts. Cultural attitudes to bed-wetting contribute to this variation and have implications for choice of therapy, both in Jamaica and elsewhere.

Enuresis en estudiantes de una escuela primaria / Enuresis in elementary school children

Se presentan los resultados de un estudio de enuresis en estudiantes de una escuela pública en el Cantón de la Unión, Provincia de cartago. El grupo estudiado abarcó todos los alumnos de primero y de sexto grados (320 y 228 respectivamente) de ambos sexos. Se encontró que 18,4% y 6,2% de los estudiantes de primero y sexto grados respectivamente presentaron enuresis. La diferencia por sexo encontrada es menor en los alumnos de primer grado (19%) en el sexo masculino y 17,3% en el sexo femenino), que en los de sexto grado en los cuales se encontró una diferencia mayor (7,4% en el sexo masculino y 4,7% en el femenino). Respecto a antecedentes en ambos padres, se encontró que cuando ambos padres han presentado enuresis, la posibilidad de tener hijos enurepeticos, es de 68,2% lo que disminuye cuando sólo uno de los padres presenta enuresis (45,5% con el padre y 51,4% con la madre

Aspectos clínicos de enurese, sonilóquios e pesadelos na infância / Enuresis, sleep-talking and night mares in children: clinical evaluation

Avaliou-se a anamnese e a semiologia neuropediátrica em 146 crianças de 3 a 7 anos de idade, buscando suas relaçöes com enurese, sonilóquios e pesadelos. Os pacientes foram tomados seqüencialmente dentre os que compareciam a um ambulatório de puericultura e submetidos a questionário padronizado, exame neurológico tradicional e exame neurológico evolutivo (ENE). Crianças com enurese e sonilóquios apresentavam mais comumente alteraçöes neurológicas leves, detectáveis ao ENE. Pesadelos relacionavam-se amiúde a distúrbios do comportamento, sem anormalidades semiológicas