Children with enuresis. Most cases of primary nocturnal enuresis are caused by isolated developmental immaturity.
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Enuresis Research Today. Proceedings of the 1st International Enuresis Symposium. Kyoto, Japan, September 28-29, 1997.
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Animals↗
Childhood enuresis: 2. Enuresis: solving puzzles and finding solutions.
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Child↗
An epidemiological study of enuresis among primary school children in Isfahan, Iran.
OBJECTIVE: To estimate the prevalence of enuresis in primary school children in Iran and to determine the factors associated with this disorder. METHODS: A cross-sectional time-ordered study was performed at the Faculty of Medicine, Isfahan Medical University, Isfahan, Iran from September 2005 to January 2006. A total of 4500 self-administered questionnaires were distributed to parents of children aged 6-12 years attending 30 primary schools. RESULTS: From an overall response rate of 69.9%, enuresis was reported in 216 children (7%), comprising 6.2% for nocturnal enuresis according to ICD10 and 3.3% according to DSM IV, 0.5% for diurnal enuresis and 0.8% for combined day and night wetting. Primary nocturnal enuresis was reported in 166 children (5.3%). Seventy-one (50.7%) of the 140 children with nocturnal enuresis had > or =3 wet nights per week. A positive family history in father and mother was seen in 51% and 39% of children with primary nocturnal enuresis respectively. Using logistic regression analysis, younger age (p < 0.002), gender (p < 0.0001) and low level of education of mother (p < 0.028) were significant predictors of enuresis. Positive history of enuresis in father was a significant predictor of primary nocturnal enuresis (p < 0.012). CONCLUSION: The prevalence of nocturnal enuresis in Iran is lower than those reported in western countries, however, higher percentage demonstrated severe enuresis. The prevalence of diurnal enuresis is lower than previous studies. Age, gender and the educational level of the mother are the main risk determinants of enuresis and the prevalence of primary nocturnal enuresis appears to be significantly related to positive history of enuresis in father.
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Enuresis: prevalence, risk factors and urinary pathology among school children in Istanbul, Turkey.
BACKGROUND: Enuresis is a common problem among children and adolescents, and can lead to important social and psychological disturbances. The aim of the present study was to establish the prevalence of enuresis among school children and determine the risk factors associated with this disorder. METHODS: A cross sectional population-based study was conducted in 1576 children. The pupils enrolled in the study were chosen randomly from 14 primary schools located in seven different regions of Istanbul. Data were collected via a questionnaire completed by parents. Enuretic children were invited to the pediatric nephrology outpatient clinic of Cerrahpasa Medical School, Istanbul, Turkey. A detailed history was taken, physical and ultrasonographic examinations, urinalysis and urine culture were performed. The relationship between the prevalence of enuresis and the patients' age, gender, region, the parental educational level and employment status, number of family members, and the family's monthly income were tested by means of chi(2 ) and logistic regression analysis. The comparison between the two enuretic groups (monosymptomatic nocturnal enuresis group vs diurnal enuresis only and diurnal-nocturnal enuresis group) regarding the sociodemographic factors were tested with the chi(2) test and P < 0.05 was accepted as statistically significant. RESULTS: The study group was composed of 1576 school children aged between 6 and 16 years. The overall prevalence of enuresis was 12.4%. When the chi(2) test was used, a significant relationship was found between the prevalence of enuresis and age, educational level of the father, the family's monthly income, and number of family members. However, when logistic regression analysis was applied, there was a statistically significant relationship only between enuresis, and age and number of family members. In the whole group, monosymptomatic enuresis nocturna was found to be more common in boys. When the two enuretic children groups (monosymptomatic nocturnal, diurnal only and nocturnal-diurnal enuretics) were compared with each other regarding gender, parental educational and employment status, and number of family members, statistically significant differences were found. Both maternal and the paternal low educational status were found to be associated with monosymptomatic enuresis nocturna. Likewise, monosymptomatic enuresis nocturna was found to be more common in the children of the unemployed mothers, while diurnal enuresis was more common in the children of unemployed fathers. Nocturnal enuresis was found to be associated with large families. No statistically significant difference was demonstrated between the two groups of enuretics regarding age and family income levels. The rate of urinary abnormalities in the whole group was 7.1%. CONCLUSIONS: Enuresis is a common problem among school children and associated urinary abnormalities are not uncommon. Identification of children at risk is an essential first step before choosing the individualized management for each enuretic child.
Adolescent↗
Nocturnal enuresis in the adolescent: a neglected problem.
OBJECTIVE: To assess the features of adolescent bedwetters, as few data are available on enuresis in this age group. PATIENTS AND METHODS: A specific database for adolescents and young adults was created with the collaboration of various specialists (paediatricians, urologists, gynaecologists, psychiatrists). Questions focused on family and personal history, stressful events, age of attaining urinary and fecal control, characteristics of enuresis (primary vs secondary, monosymptomatic vs enuresis associated with daytime urinary symptoms), school performance, diagnostic examination and physical examinations, and treatment and its response. RESULTS: Data were collected from 107 enuretic adolescents (mean age 15.3 years, median 14, range 13-23; 63 males and 44 females). A positive family history for enuresis was recorded in 82%. Enuresis was primary in 79 patients (74%), secondary in 28 (26%), monosymptomatic in 76 (71%) and associated with daytime urinary symptoms in 31 (29%). In males monosymptomatic enuresis was significantly more frequent than in females (P < 0.01). Urinary tract infections were reported by 13 patients, all females; eating disorders (anorexia, polyphagia) were present in six. In 85 patients (80%) enuresis was considered severe (> or = three nights/week). Of the 107 patients, 27 (20%) had never consulted a doctor about their problem and 43 (40%) had received no therapy; 66 received desmopressin monotherapy, with a good response (half the number of wet nights) in 44 (79%). There was no relation between response to desmopressin and gender, age, type and severity of enuresis or positive family history of enuresis. Eight patients were provided with a nocturnal alarm but this was not tolerated by two. Altogether, 25 patients refused any therapy or did not comply with the given therapy. CONCLUSIONS: Enuresis can persist into adolescence and be a significant problem; 80% of these patients had severe enuresis and 31% also had associated daytime urinary symptoms, with 40% receiving no previous therapy. The treatment of enuresis can be particularly difficult at this age; 22% of patients did not respond to desmopressin and 23% had low compliance with the given therapy. Enuresis in adolescents requires further study; hopefully more enuretic children will receive adequate treatment before reaching adolescence.
Adolescent↗
Bladder reservoir function in children with monosymptomatic nocturnal enuresis and healthy controls.
PURPOSE: We investigated bladder reservoir function in children with monosymptomatic nocturnal enuresis and in healthy controls. MATERIALS AND METHODS: A total of 18 children with monosymptomatic nocturnal enuresis and 119 controls who were 7 to 13 years old were recruited. Children completed frequency volume charts and measurements of nocturnal urine production. Mean diuresis in the period preceding each voiding was calculated. Those with enuresis were grouped according to bladder capacity and hospitalized for 4 nights, including a baseline night and 3 with an oral water load. Enuresis volumes and post-void residual volume were estimated, allowing the calculation of bladder volume at the time of enuresis. RESULTS: Nine children with monosymptomatic nocturnal enuresis were characterized as having normal bladder capacity and 9 had decreased bladder capacity. We found large intra-individual variability in daytime voided volume in all 3 groups of participants. Children with enuresis and small bladder capacity generally voided with volumes close to maximal voided volume. A total of 93 enuresis episodes were recorded. Large intra-individual variability was seen in bladder volume at enuresis and it was lower than maximal voided volume in more than 50% of episodes. Variability in bladder volume at enuresis was greatest in the patient group with decreased bladder capacity. We found a significant correlation between diuresis and bladder capacity in all groups during the day and night. CONCLUSIONS: There is a great intra-individual diurnal variability in voided volume in children with enuresis and in healthy children. Enuresis seems to occur at bladder volumes that are smaller and larger than the maximal voided volume obtained from voiding charts.
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A preventive context for enuresis.
Prevention of enuresis has not been studied directly. Positive results from a randomized clinical trial evaluating early intervention for children at risk for enuresis would establish the value of prevention and help to promote its practice. Enuresis is not a disease process, and therefore a clinical trial may never be conducted, but the treatment of enuresis can be a threat to the child's health, as can the parental, professional, and peer response to the wetting. Children cannot die from wetting the bed. They can die from the medicine given to them to stop the bed wetting. Wet beds cannot cause contusions, abrasions, and concussions. Punishments administered for bed wetting can. Urine cannot cause emotional disturbance. Ridiculing, admonishing, or singling out a child for urinating can. Numerous suggestions are available to help to prevent the problems linked to enuresis, and perhaps to prevent enuresis itself. They range from the simple (e.g., waiting for the problem to resolve itself) to the very complex (e.g., promoting a change in the DSM-III criteria). The preventive suggestions in this paper are by no means exhaustive. Rather, they are an example of suggestions that can come from the literature on each aspect of enuresis: diagnosis, incidence, etiology, and treatment. A review of this literature reveals that, no matter which aspect of enuresis a researcher investigated or which body of findings a clinician examined, increased prevention could be the outcome. Child health should be the provider's abiding concern when choosing a treatment for enuresis. Management by parents and health care providers constitutes the primary threat that enuresis poses to emotional and physical health. Historically, the choice of treatment was governed more by the possibility of continence than by possible side effects on child health. The decision to use a treatment should be guided by the pediatrician's assessment of the child's readiness, willingness of the child and parents, and family resources. Although treatment is evolving, some interventions are highly rigorous and appear to focus primarily on dryness (e.g., the original dry-bed training). Treatment for enuresis has not yet been conceptualized into an encompassing context of health as have other medical maneuvers (e.g., physical examinations are now part of health maintenance). Enuresis is a presenting complaint that is not of itself a threat to health. Prevention, therefore, is its most appropriate context, and the pediatrician is the primary promoter of that context.
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Is routine urinary tract investigation necessary for children with monosymptomatic primary nocturnal enuresis?
OBJECTIVES: To investigate in a prospective study the role of bladder function and to compare the results of urinary tract ultrasonography and urinalysis in children with and without primary nocturnal enuresis because, although this is a common problem in children, the etiology and mechanisms of the disorder have not been elucidated. METHODS: The study included 106 children with monosymptomatic primary nocturnal enuresis and a control group of 57 children with no history of voiding dysfunction, aged 5 to 19 years. All children underwent urinalysis, bladder and upper urinary tract ultrasonography, and uroflowmetry. The bladder capacity, bladder wall thickness, and postvoid residual volume were measured using ultrasonography. The findings were compared between the enuresis and control groups according to age: 5 to 9 years, 10 to 14 years, and 15 to 19 years. RESULTS: The mean age was 9.6 +/- 3.1 years in the nocturnal enuresis group and 9.4 +/- 3.3 years in the control group (P = 0.727). The mean number of defecations per week was significantly lower statistically in the enuresis group than in the control group in the age categories of 5 to 9 years and 10 to 14 years (P = 0.038 and P = 0.018, respectively), and the mean number of urinations per day was significantly higher statistically in the enuresis group than in the control group in the age groups of 5 to 9 years and 10 to 14 years (P = 0.002 and P = 0.001, respectively). The bladder capacity, bladder wall thickness, postvoid residual volume, uroflowmetry maximal flow rate, and average flow rate were not significantly different statistically between the children with primary nocturnal enuresis and the control group in the three age brackets. Urinary infection was detected in 2 children (1.88%) in the nocturnal enuresis group and none of the children in the control group (P = 0.547). Upper urinary tract abnormalities detected by ultrasonography were seen in 3 children (2.83%) in the nocturnal enuresis group and 1 child (1.75%) in the control group, revealing no statistical significance (P = 0.671). CONCLUSIONS: Our findings show that the ultrasonographic and uroflowmetry findings on bladder function and the upper urinary system and the incidence of urinary infection are similar in children with and without nocturnal enuresis. Obtaining a voiding and elimination diary in conjunction with a good history may be beneficial in children with monosymptomatic primary nocturnal enuresis. In addition, routine urinalysis may be unnecessary in the evaluation of children with monosymptomatic primary nocturnal enuresis after obtaining a careful and complete history of the voiding dysfunction.
Adolescent↗
The impact of attention deficit hyperactivity disorders on brainstem dysfunction in nocturnal enuresis.
PURPOSE: In a specialized university setting the prevalence of attention deficit hyperactivity disorder in general and particularly the inattentive subtype attention deficit hyperactivity disorder of the predominantly inattentive subtype is highly increased. We replicated previous research findings that enuresis is associated with a brainstem deficit and investigated the impact of attention deficit hyperactivity disorder on this brainstem deficit in enuresis. MATERIALS AND METHODS: Electromyography recorded startle eye blink modification with and without attentional modulation was used to measure brainstem functioning in 158 children between 6 and 12 years old. Performance in 3 enuresis groups, including children with enuresis, enuresis plus attention deficit hyperactivity disorder of the predominantly inattentive subtype and enuresis plus attention deficit hyperactivity disorder combined, respectively, was compared with that in normally developing controls and in children with attention deficit hyperactivity disorder subtypes without enuresis. RESULTS: In an automatic attentional task the enuresis groups showed decreased brainstem inhibition compared to that in the control and attention deficit hyperactivity disorder groups (p <0.006). In a controlled attentional task children with and without enuresis who had attention deficit hyperactivity disorder of the predominantly inattentive subtype were unable to show attentional modulation in all age groups (p <0.02). CONCLUSIONS: Startle eye blink modification research reveals a brainstem inhibition deficit in children with enuresis, which could explain why they are unable to remain dry at night. When additional attention is allocated to specific trials in the task, children with attention deficit hyperactivity disorder of the predominantly inattentive subtype fail to optimize sensory gating. With respect to enuresis, this could result in an identification problem of bladder signals, leading to an inadequate or absent arousal effect in attention deficit hyperactivity disorder of the predominantly inattentive subtype.
Attention Deficit Disorder with Hyperactivity↗
Nocturnal enuresis in a nationwide twin cohort.
We studied the occurrence of nocturnal enuresis (bedwetting) after the age of 4 years, using a questionnaire in a well-defined population, the Finnish Twin Cohort, which consists of 11,220 subjects aged 33-60 years, including 1298 monozygotic and 2419 dizygotic twin pairs. Structural equation modeling techniques were used to estimate variance components to compare different genetic models. Females reported enuresis in childhood "often" in 3.4% (males in 4.0%) and "sometimes" in 5.7% (8.0%). As adults, females had experienced enuresis "weekly" in 0.3% (males in 0.2%) and "monthly" in 0.07% (0.1%). Those who had experienced enuresis in childhood had had "at least sometimes" enuresis as adults in 5.4% of males and in 5.5% of females. Among those who reported they never had experienced enuresis as adults, 70.8% of males and in 77.9% of females had never experienced enuresis in childhood. For enuresis in childhood, the probandwise concordance rate was 0.43 for monozygotic and 0.19 for dizygotic pairs, and in adults 0.25 and 0, respectively. The proportion of total phenotypic variance attributed to genetic influences (due to dominance) was 67% in males (95% confidence interval 57-76%) and 70% in females (61-78%) in childhood enuresis. In conclusion, nocturnal enuresis is common in childhood and rare in adulthood. Our results confirm the central role of genetic liability in enuresis.
Adult↗
Effectiveness of adenotonsillectomy in the resolution of nocturnal enuresis secondary to obstructive sleep apnea.
OBJECTIVES: To investigate the relationship between obstructive sleep apnea (OSA) syndrome and nocturnal enuresis (NE) in patients who required tonsillectomy or adenoidectomy. STUDY DESIGN: Retrospective chart review with prospective collection of data. METHODS: All charts of patients ages 2 to 18 years that had tonsillectomy or adenoidectomy over a 44 month period were reviewed for presence of NE and indication for surgery. Those patients with a positive history of both NE and OSA were surveyed to determine whether there was no change in enuresis, decreased enuresis, or no enuresis postoperatively. RESULTS: Three hundred twenty-six children who had undergone tonsillectomy or adenotonsillectomy had data regarding enuresis available in their charts. One hundred seven of these 326 (32.8%) children had a positive history of enuresis. Of the 107 children with a positive history, 44 (41.1%) were female, and 63 (58.9%) were male. All 107 children with enuresis underwent adenotonsillectomy for OSA. None of the children who had a history of recurrent adenotonsillitis or chronic tonsillitis reported enuresis as a presenting symptom. Of the 107 children with a positive preoperative history of NE, 57 (53.3%) agreed to participate in the second phase of the study. Postoperatively, 61.4% (35) of the children were free of enuresis, 22.8% (13) had a decrease in enuresis, and 15.8% (9) had no change in enuresis. A chi-square test showed a statistically significant difference among the groups (P < .0001). CONCLUSIONS: NE is a relatively common finding in children with OSA symptoms. NE resolves or markedly improves in the vast majority of these patients postoperatively.
Adenoidectomy↗
[Long-term results of systematic treatment for nocturnal enuresis based on overnight simultaneous monitoring of electroencephalography and cystometry].
BACKGROUND: The long-term results of systematic treatment based on overnight simultaneous monitoring of electroencephalography (EEG) and cystometry in the patients with enuresis were evaluated. METHODS: From January to December a total of 213 patients were classified into 3 types. Enuresis Type I: such cases show a normal cystometrogram (CMG) with an awakening response on the EEG before enuresis, but they do not awake. Enuresis Type IIa; such cases show a normal CMG without an awakening response on the EEG. Enuresis Type IIb: such cases show an abnormal CMG with no awakening response on the EEG. When such cases enter the deep sleep stage, continuous uninhibited contractions of the bladder are observed on the CMG. 136 cases were of Type I, 20 cases of Type IIa, and 57 cases of Type IIb. RESULTS: Out of 213 patients who were followed up for 2 years, cured cases were 94 (44%), effective cases were 81 (38%) and unchanged cases were 38 (18%). In 136 patients with Type I, cured cases were 71 (52%), effective cases were 50 (37%) and unchanged cases were 15 (11%). In 20 patients with Type IIa, cured cases were 8 (40%), effective cases were 9 (45%) and unchanged cases were 3 (15%). In 57 patients with Type IIb, cured cases were 15 (26%), effective cases were 22 (39%) and unchanged cases were 20 (35%). The age of the effective group, which included cured cases and effective cases, was significantly higher than that of the unchanged group. In enuresis Type I, the percentage of the patients with incontinence in daytime were significantly in the unchanged group than in the effective group. No significant differences in the frequency of enuresis and the percentage of the patients who had awakened spontaneously by urinary sensation were found between the two groups. CONCLUSION: The therapeutic response was best in enuresis Type 1 and worst in enuresis Type IIb. The patients, in whom not only frequency of enuresis but also type of enuresis was unchanged by systematic treatment for two years, was approximately 10% across the types. Accordingly they were thought to be non-responders to this systematic treatment.
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Enuresis: point prevalence and associated factors among Turkish children.
The aim of this study was to establish the prevalence and associated factors of enuresis nocturna and to better understand nocturnal bladder control in Turkish children. A randomized epidemiological study was performed among primary school children, aged four to 12 years, living in Aydin, Turkey. After data collection via a self-administered questionnaire completed by the parents, data of 2,300 children were accepted for the analysis. The overall prevalence of reported marked nocturnal enuresis (at least weekly) was 11.6 percent and of day wetting 0.8 percent. Enuresis was more frequent in boys than in girls. Age, family history of enuresis, large family size, urinary tract infections and low parental socioeconomic class were all statistically associated with reported enuresis nocturna. Familial history among the enuretics and non-enuretics was 40.7 percent and 9.5 percent, respectively. Of the enuretics, 11 percent were treated professionally, 65 percent were treated traditionally by the family and 25 percent sought no help to manage the enuresis. A reference age of 2.9 +/- 1.6 years was calculated for nocturnal bladder control of the children studied. These results suggest that prevalence of enuresis nocturna and development of bladder control in Turkish children are not so different from that seen in other European and Middle East countries, and that the most significant factors associated with enuresis are socioeconomic and familial ones. Turkish families do not have a high level of concern about enuresis, even in the older children. This study demonstrated that enuresis is a sizable problem in Turkey and that a great ignorance about enuresis by both parents and physicians exits.
Chi-Square Distribution↗
Survey of childhood enuresis in the Ehor community, the EDO State, Nigeria.
A community survey of enuresis was carried out in November/December 2002 among 300 apparently healthy children aged 5-16 years selected systematically from the Ehor Local Government Area in Edo State, Nigeria. This was done with the aim of ascertaining the true prevalence of the disease and the contributions of some organic causative factors. The overall prevalence of enuresis was 21.3%. Of the 64 children who were enuretic, 58 (91%) had only nocturnal enuresis. No strict daytime enuresis was recorded. Combined daytime and night time enuresis accounted for only six (9.4%) cases. Ninety-four percent of cases of enuresis were primary, while only six were secondary. Prevalence of enuresis declined significantly with increasing age (chi2= 14 .93, df= 3; p = 002). There was a strong association between enuresis and family history of bed wetting (more so with siblings) (chi2 = 45.09, p < 0.000). Though not statistically significant, enuresis was more common in males, in children drawn from families of poor socio-economic status, among first order births, and among those with asymptomatic bacteriuria. Also, there was no significant association between enuresis and hemoglobin genotype. Organic conditions played a minimal role in the etiology of enuresis in the study location, but the morbidity occurred frequently enough to warrant health attention. A community approach is advocated because only an insignificant proportion is seen in orthodox health facilities.
Adolescent↗
Childhood nocturnal enuresis in The Netherlands.
OBJECTIVES: To assess the prevalence of nocturnal enuresis in school children aged 5 to 15 years, and to investigate the association of bedwetting with ethnicity, the educational level of the parents, and the type of education (mainstream or special) received by the child. METHODS: Data were obtained for 5360 children in mainstream education and 2571 children in special education. The data were weighted to calculate estimates representative of the Dutch population. Nocturnal enuresis was examined in children 5 or 6 years of age who wet their bed at least twice in the 4 weeks previous to questioning, and in children 7 years of age and older who did so at least once in the previous 4 weeks. RESULTS: The prevalence of nocturnal enuresis was 6%; 15% in the 5 to 6-year-age group and 1% in the 13 to 15-year age group. Marked enuresis (at least twice a week) was reported in 4%. Nocturnal enuresis was more common in Turkish/Moroccan (14%) than in Dutch children (6%). The educational level of the parents was not significantly related to nocturnal enuresis. Children in special education more frequently reported nocturnal enuresis than children in mainstream education (14% and 6%, respectively). This was especially true for children in schools for the mentally retarded as compared to children in mainstream education ¿odds ratio [OR] in boys 3.21 (99% confidence interval [CI] 2.26 to 4.55) and OR in girls 4.25 [99% CI 2.61 to 6.92]¿. CONCLUSIONS: Nocturnal enuresis occurs most frequently among mentally retarded children. Children attending special education schools for reasons other than mental retardation are also at a higher risk of experiencing nocturnal enuresis than children attending mainstream education schools. Nocturnal enuresis is more prevalent in Turkish/Moroccan children than in Dutch children.
Adolescent↗
Epidemiology of childhood nocturnal enuresis in Malaysia.
OBJECTIVES: To estimate the prevalence of nocturnal enuresis in primary school children in Malaysia and to determine the factors associated with primary nocturnal enuresis. METHODS: This was a cross-sectional survey. A total of 3371 self-administered questionnaires were distributed to parents of children aged 7, 9 and 12 years attending four primary schools in the city. The ICD-10 definition of enuresis was used. RESULTS: From an overall response rate of 73.8%, nocturnal enuresis was reported in 200 children (8%), primary nocturnal enuresis in 156 children (6.2%) and secondary nocturnal enuresis in 44 children (1.8%). Fifty-three percent of those with primary enuresis had a positive family history, and 54% had two or more wet nights per week. Eighty-seven percent had not sought any form of treatment despite 74% admitting to being embarrassed. Using logistic regression analysis, only three factors were significant predictors of primary nocturnal enuresis. These were: (i) younger age (P < 0.001); (ii) male sex (P < 0.033); and (iii) Indian ethnic group (P < 0.044) compared to Chinese. CONCLUSION: The prevalence of nocturnal enuresis in urban-dwelling Malaysian children is similar to that reported from Korea and Taiwan but appears to be lower than that reported from developed countries. Predictive factors associated with primary nocturnal enuresis included lower age group, male sex and Indian ethnicity.
Age Distribution↗
An epidemiological study of enuresis in Korean children.
OBJECTIVE: To estimate the prevalence of enuresis in children of elementary school age, to evaluate the impact of enuresis on these children and their parents, and to identify the methods and effectiveness of managing enuresis. Subjects and methods A randomly selected cross-sectional study was conducted in one elementary school in each urban ward (nine schools) in Pusan, Korea. The parents of these 12 570 children aged 7-12 years were asked to complete questionnaires which included items about the presence and frequency of enuresis, its perceived impact and management. Enuresis was defined as an episode of wetting occurring at least once per month. RESULTS: The overall response rate to the questionnaire was 55.8% (girls 28.2%, boys 27.6%). The prevalence of nocturnal, diurnal and combined enuresis was 9.2%, 2.2% and 1.4%, respectively. The overall prevalence of enuresis declined with age from 20.4% at 7 years old to 5.6% at 12 years old; 342 (57.0%) parents and 318 (55. 6%) children were concerned about enuresis. The common self-help strategies were waking the child at night to void (38.1%) and restriction of water intake (25.7%). Of the enuretic children, only 13.7% had consulted a health worker. CONCLUSION: The prevalence rates for enuresis in Pusan are similar to those reported from European countries. Enuretic children and their parents were moderately concerned about enuresis and the parents primarily used self-management within the family.
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