The influence of delay elimination communication on the prevalence of primary nocturnal enuresis—a survey from Mainland China

Abstract

Aims A pilot survey shows that primary nocturnal enuresis (PNE) prevalence has increased significantly during the past decade in Mainland China. Whether it is related to the delay of elimination communication (EC) is unclear. This study retrospectively investigated the influence of delayed EC on the PNE prevalence in children and adolescents in mainland China. Methods A cross‐sectional study of PNE prevalence was performed by distributing 19 500 anonymous self‐administered questionnaires to parents in five provinces of mainland China from July 2017 to October 2017. The questionnaires included sociodemographic data, family caregivers’ information, and details about the disposable diapers (DD) usage, EC commencement date, psychological disorders, lower urinary tract symptoms, and family history of PNE in children and adolescents. The 2017 PNE prevalence was compared with that of 2006 in Mainland China. Results The total response rate was 97.04% (18 631 of 19 500) and 92.39% (18 016 of 19 500) qualified for statistical analysis. The PNE prevalence in 2017 has increased significantly compared to that of 2006 (7.30% vs 4.07%, P < 0.001). The PNE prevalence in children with EC starting before 6 months of age was significantly lower than those who start after 12 months of age. The longer DD were used and the later the beginning of EC, the higher the PNE prevalence was found. Conclusions The PNE prevalence in Mainland China has increased significantly during the past 10 years. A longer use of DD and later onset of EC may be risk factors for PNE.

Prevalence and risk factors of nocturnal enuresis among children ages 5–12 years in Xi’an, China: a cross-sectional study

“…However, compared to the findings of the 2005 study in Xi'an, our sample's prevalence of NE was lower, 3.99%. This lower prevalence might have been due to improvements in income, parental occupation, parental education level, and living habits [9].…”

“…We also found that with the widespread use of DD, younger children had used it much longer than the older (Supplementary Table 3, Additional File 1). Due to increases in income, parents may prolong the use of DD and delay toilet training, thus promoting the occurrence of NE [9]. Joinson et al [27] suggested that delayed toilet training (after 24 months) was likely to induce persistent urine accidents during the daytime.…”

“…Furthermore, Ramírez-Backhaus et al found that the prevalence of NE in Spanish schoolage children was 7.8% [8]. In China, NE prevalence was found to vary by region, ranging from 4.07 to 10.3% [9,10], and NE occurred more frequently with boys [3,11].…”

Prevalence and risk factors of overactive bladder in Chinese children: A population‐based study

“…Many potential risk factors of OAB in children remain unclear. The effect of the elimination communication (EC) start time on NE has recently been reported . EC is an infant‐led, caregiver‐operated practice that helps infants to gradually develop self‐controlled urination and defecation.…”

“…The effect of the elimination communication (EC) start time on NE has recently been reported. 6 EC is an infant-led, caregiver-operated practice that helps infants to gradually develop self-controlled urination and defecation. In detail, a caregiver uses the infant's cues or natural timing, or transitions and intuition to recognize when the child needs to eliminate; the caregiver then teaches the infant to eliminate in a potty, toilet or any other appropriate place at predictable times and in a gentle position.…”