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. 2021 Feb;32(2):359-365.
doi: 10.1007/s00192-020-04345-x. Epub 2020 May 30.

Childhood nocturnal enuresis-a marker for pelvic floor disorders and urinary tract symptoms in women?

Jwan Al-Mukhtar Othman  1   2 , Sigvard Åkervall  3 , Mattias Molin  4 , Maria Gyhagen  3   5
Affiliations

Childhood nocturnal enuresis-a marker for pelvic floor disorders and urinary tract symptoms in women?

Jwan Al-Mukhtar Othman et al. Int Urogynecol J. 2021 Feb.

Abstract

Introduction and hypothesis: A systematic survey on the association between childhood nocturnal enuresis (CNE) and adult pelvic floor disorders (PFDs) has not been presented previously. The aim was to describe the prevalence of PFDs and lower urinary tract symptoms in nulliparous women, with or without a history of CNE, at the age of ≥ 5 years.

Methods: This national survey of urinary (UI) and fecal incontinence (FI) and symptoms of pelvic organ prolapse (sPOP) was a random sample of 20,000 nulliparous women aged 25-64 years conducted in 2014. Women ≥ 5 years of age having CNE were compared with those without the condition. Fisher's exact test and logistic regression adjusted for BMI and age were used to analyze differences between groups.

Results: The response rate was 52% and 10.2% of adult women reporting CNE. One or more PFDs occurred in 38.3% of women with CNE compared to 23.8% in those without CNE (p < 0.0001). Mixed UI had the strongest association with CNE, odds ratio (OR) 2.63 (95% CI 2.03-3.40). The rate of FI was 11.2% in the non-CNE group and 16.8% in those with CNE (p < 0.0001) and sPOP 2.6% in the non-CNE and 4.8% in the CNE group (p = 0.0004), respectively. The prevalence of lower urinary tract symptoms was consistently higher in women with a history of CNE: overactive bladder 32.6% versus 18.4% (OR 2.34 95% CI 2.03-3.40), daytime micturition ≥ 8/day 29.6% versus 24.0% (p < 0.0001), and nocturia ≥ 2/night 12.4% versus 7.8% (p < 0.0001) in the CNE group.

Conclusion: PFDs and lower urinary tract symptoms in nulliparous women were approximately doubled in women with a history of CNE and could therefore act as a strong confounding factor.

Keywords: Childhood nocturnal enuresis; Fecal incontinence; Lower urinary tract symptoms; Nulliparous women; Pelvic floor disorders; Pelvic organ prolapse.

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Conflict of interest statement

M Gyhagen has received honoraria from SCA/Essity and Astellas Pharma for speaker participation. J Al-Mukhtar Othman has received honoraria from Astellas Pharma for speaker participation. M Molin and S Åkervall report no conflict of interest.

Figures

Fig. 1
Fig. 1
Risk for pelvic floor disorders in nulliparous women with a history of childhood nocturnal enuresis. UI denotes urinary incontinence; moderate and severe UI was defined according to Sandvik’s severity index.15 SUI denotes stress UI; UUI denotes urge UI; MUI denotes mixed UI; OAB denotes overactive bladder; sPOP denotes symptoms of pelvic organ prolapse; FI denotes fecal incontinence; PFD denotes pelvic floor disorder. CNE denotes childhood nocturnal enuresis. *Odds ratio and 95% confidence limits were calculated using logistic regression analysis with adjustment for age and BMI (kg/m2)
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References

    1. Austin PF, Bower SB, Bower W, Chase J, Franco I, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization Committee of the International Children’s Continence Society. Neurourol Urodyn. 2016;35:471–481. doi: 10.1002/nau.22751. - DOI - PubMed
    1. Milsom I, Altman D, Cartwright R, et al. Epidemiology of urinary incontinence (UI) and other lower urinary tract symptoms (LUTS), pelvic organ prolapse (POP) and anal (AI) incontinence. In: Abrams P, Cardozo L, Wagg A, Wein A, et al., editors. Incontinence. 6. Paris: Health Publications Ltd; 2017. pp. 6–16.
    1. Zhang L, Zhu L, Xu T, et al. A population-based survey of the prevalence, potential risk factors, and symptom-specific bother of lower urinary tract symptoms in adult Chinese women. Eur Urol. 2015;68:97–112. doi: 10.1016/j.eururo.2014.12.012. - DOI - PubMed
    1. Loeys B, Hoebeke P, Raes A, Messian L, de Paepe A, Van de Valle J. Does monosymptomatic enuresis exist? A molecular genetic exploration of 32 families with enuresis/incontinence. BJU Int. 2002;90:76–83. doi: 10.1046/j.1464-410X.2002.02775.x. - DOI - PubMed
    1. von Gontard A, Heron J, Joinson C. Family history of nocturnal enuresis and urinary incontinence: results from a large epidemiological study. J Urology. 2011;185:2303–2307. doi: 10.1016/j.juro.2011.02.040. - DOI - PubMed