Urinary incontinence and nocturia in healthy schoolchildren

Mattsson, Sven

doi:10.1111/j.1651-2227.1994.tb13179.x

“…A crença de que sintomas urinários em crianças não necessitam de tratamento porque tendem a desaparecer espontaneamente é incorreta, com exceção para a enurese noturna monossintomática, que apresenta uma taxa de resolução de 15% ao ano 1 . Apesar disso, esse foi o sintoma que mais levou os familiares a buscar tratamento, assim como em outros estudos internacionais na Sué-cia 17,18 . Urinar na cama à noite é mais preocupante para os pais do que apresentar incontinência diurna, mesmo que a criança tenha necessidade de trocar a roupa várias vezes ao dia 16 .…”

Section: Discussionunclassified

Investigation of voiding dysfunction in a population-based sample of children aged 3 to 9 years

Mota¹,

Victora²,

Hallal³

2005

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Objective: To describe voiding patterns and related dysfunctions in a population-based sample of children aged 3 to 9 years. Methods:A cross-sectional population-based survey including 580 children. A probabilistic sample of households in the urban area of Pelotas in southern Brazil was selected following a multiple-stage protocol. Voiding and fecal patterns were investigated using the dysfunction score created by Farhat et al. and modified by the addition of high urinary frequency (more than eight times a day). Boys with scores above eight and girls above five were clinically investigated, as well as a sub-sample of the remaining children.Results: Nocturia (60.4%), urinary urgency (49.7%) and holding maneuvers (42.1%) were the most frequently reported symptoms. The prevalence of enuresis was 20.1% in boys and 15.1% in girls. The prevalence of urinary dysfunction was 22.8%. Most symptoms were more frequently reported by girls and younger children. Among girls, low socioeconomic level was related to an increased prevalence of enuresis and straining to urinate, while among boys urgency was more common among the poor. Only 10.5% of the parents of the children with voiding dysfunction consulted a doctor because of their problems. Conclusions:The voiding symptoms studied presented high prevalence rates, and therefore should be investigated in clinical practice, with direct questions about each symptom, aiming to diagnose voiding dysfunction.J Pediatr (Rio J). 2005;81(3):225-32: Enuresis, toilet training, urinary tract, urinary incontinence, urination disorders. ResumoObjetivo: Descrever os hábitos miccionais e suas disfunções em uma amostra populacional de crianças de 3 a 9 anos.Métodos: Delineamento transversal, incluindo 580 crianças. Uma amostra probabilística de domicílios da zona urbana da cidade de Pelotas (RS) foi selecionada em múltiplos estágios. Os hábitos miccionais e fecais foram avaliados com o escore de disfunção miccional proposto por Farhat et al. e modificado pela equipe de pesquisa com acréscimo do sintoma freqüência urinária superior a oito vezes ao dia. Os meninos com pontuação maior que oito e as meninas com pontuação maior que cinco foram reavaliados clinicamente, assim como uma subamostra dos demais.Resultados: Os sintomas miccionais mais freqüentes foram noctúria (60,4%), urgência miccional (49,7%) e manobras de contenção (42,1%). A prevalência de enurese foi de 20,1% em meninos e 15,1% em meninas. A prevalência de disfunção miccional pelo escore Farhat et al. foi de 24,2%. A maioria dos sintomas foi mais freqüente entre as meninas e entre crianças mais jovens. As meninas de nível econômico baixo apresentaram maior freqüência de enurese e força para urinar, enquanto que, entre os meninos, a urgência miccional foi mais comum entre os mais pobres. Apenas 10,5% dos pais de crianças com disfunção haviam levado seu filho ao médico por causa dos sintomas. Conclusões:Os sintomas miccionais apresentam prevalências altas e devem ser investigados ativamente nas consultas de rotina, com perguntas...

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“…1 Despite this, it was this symptom that most caused families to seek treatment, in common with other international studies in Sweden. 17,18 Nocturnal bed wetting is more worrying for parents than presenting diurnal incontinence even if the child needs to change clothes several different times a day. 16 In an evaluation of schoolchildren aged 4 to 6 in Australia, 12 just 16% of all of the children with urinary incontinence received medical care.…”

Section: Discussionmentioning

confidence: 99%

Investigação de disfunção miccional em uma amostra populacional de crianças de 3 a 9 anos

Mota¹,

Victora²,

Hallal³

2005

J. Pediatr. (Rio J.)

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Objective: To describe voiding patterns and related dysfunctions in a population-based sample of children aged 3 to 9 years. Methods:A cross-sectional population-based survey including 580 children. A probabilistic sample of households in the urban area of Pelotas in southern Brazil was selected following a multiple-stage protocol. Voiding and fecal patterns were investigated using the dysfunction score created by Farhat et al. and modified by the addition of high urinary frequency (more than eight times a day). Boys with scores above eight and girls above five were clinically investigated, as well as a sub-sample of the remaining children.Results: Nocturia (60.4%), urinary urgency (49.7%) and holding maneuvers (42.1%) were the most frequently reported symptoms. The prevalence of enuresis was 20.1% in boys and 15.1% in girls. The prevalence of urinary dysfunction was 22.8%. Most symptoms were more frequently reported by girls and younger children. Among girls, low socioeconomic level was related to an increased prevalence of enuresis and straining to urinate, while among boys urgency was more common among the poor. Only 10.5% of the parents of the children with voiding dysfunction consulted a doctor because of their problems. Conclusions:The voiding symptoms studied presented high prevalence rates, and therefore should be investigated in clinical practice, with direct questions about each symptom, aiming to diagnose voiding dysfunction.

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“…A response to desmopressin was associated with a positive family history of nocturnal enuresis in one study [8], but not in another [9]. That children who are not enuretic do not always sleep through the night but wake up to void [10] suggests that abnormal arousal patterns are also associated with nocturnal enuresis [11].…”

Section: Introductionmentioning

confidence: 99%

Treatment of primary monosymptomatic nocturnal enuresis with desmopressin: predictive factors

Kruse

¹

,

Hellström

²

,

Hanson

³

et al. 2001

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On behalf of the Swedish Enuresis Trial (SWEET) Group (see Appendix) Objective To investigate predictive factors for the outcome of treatment of primary monosymptomatic nocturnal enuresis (PMNE) with desmopressin. Patients and methods Data from a large open multicentre study were analysed. The study comprised 399 children with PMNE who were recruited for long-term desmopressin treatment. Before treatment a history was taken and the children observed for 4 weeks. After a 6-week dose-titration period with desmopressin, the children were classi®ed into four groups depending on the response rate. Results The children who improved during desmopressin treatment were older, had fewer wet nights during the observation period and had only one wet episode during the night, mostly after midnight. Many of them did not require the maximum dose of desmopressin to become dry. No hereditary factor for the response to desmopressin was found. Conclusion Those most likely to be permanently dry with desmopressin treatment are older children who respond to 20 mg desmopressin and who do not wet frequently.

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Urinary incontinence and nocturia in healthy schoolchildren

Cited by 88 publications

References 10 publications

Investigation of voiding dysfunction in a population-based sample of children aged 3 to 9 years

Investigation of voiding dysfunction in a population-based sample of children aged 3 to 9 years

Investigação de disfunção miccional em uma amostra populacional de crianças de 3 a 9 anos

Treatment of primary monosymptomatic nocturnal enuresis with desmopressin: predictive factors

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