Evaluation of Etiological Risk Factors of Primary Monosymptomatic Enuresis

Abstract

Objective: A child who has not been dry previously, i.e., wets the bed, for more than 6 months without any lower urinary tract symptoms is considered to have primary monosymptomatic nocturnal enuresis (MNE). The aim of this study was to investigate the etiological risk factors in primary MNE. Methods: We retrospectively evaluated the medical records of children with enuresis. Children with known anatomic malformations, nonmonosymptomatic enuresis, and secondary enuresis were excluded. Only children with primary MNE were included in the study. The control group included healthy children with no history of bedwetting. The etiological risk factors were compared between the groups. Results: Eighty-nine children with primary MNE (mean age: 9.7 years) and 70 healthy children (mean age: 9 years) were included in the study. Both groups were similar for age, gender, birth type, birth weight, gestational duration, and sleep duration. The mean body mass index (BMI), mean duration of only breastfeeding, and mean duration of breastfeeding with infant formula were 19.1 and 16.8 kg/m2, 5.4 and 7.3 months, and 13.2 and 17.9 months in the enuresis group and control group, respectively, (p=0.012, p=0.005, p=0.034). The family history for enuresis was positive in 58 (65.2%) and 12 (17.1%) patients in the enuresis group and control group, respectively, (p=0.001). The multivariate regression analysis identified family history and breastfeeding as independent risk factors for enuresis (p=0.001, p=0.012). Conclusion: We have documented that high BMI, positive family history, and low duration of breastfeeding are risk factors for enuresis. The present study has shown that longer breastfeeding is protective for bedwetting.