Materiały źródłowe

• #1 Enuresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545181/

  Enuresis, commonly known as bedwetting, is a prevalent pediatric condition affecting approximately 15% of 5-year-old children. […] The prevalence of enuresis is similar across cultures and varies with age, with males affected twice as often as females. By age 4, nearly 25% of children experience frequent bedwetting; by 5, the condition affects approximately 15% of children. Once children reach 8, the incidence is 4%. However, due to the stigma associated with enuresis, many cases go unreported, making the true prevalence challenging to ascertain. […] The International Children’s Continence Society reports that 20% to 30% of children with enuresis have at least 1 mental health condition, approximately twice the rate of non-wetting children. The most frequently cited disorder accompanying enuresis is attention deficit hyperactivity disorder, but others include autism spectrum disorder, oppositional defiant disorder, and mood disorders. This link is an association, not proof of causation since enuresis can result in feelings of shame, embarrassment, and frustration, which then lead to anxiety and depression.

• #2 Nocturnal enuresis in children: Management – UpToDate

  https://www.uptodate.com/contents/nocturnal-enuresis-in-children-management

  Urinary incontinence is common, occurring in approximately 15 percent of five-year-old children. Many of these children have isolated nocturnal enuresis (monosymptomatic nocturnal enuresis or „bedwetting”). […] The management of monosymptomatic nocturnal enuresis in children will be presented here. The recommendations in this topic review are largely consistent with those of expert groups, including the International Children’s Continence Society (ICCS) and the National Institute for Health and Care Excellence. […] An overview of the causes and evaluation of nocturnal enuresis and bowel and bladder dysfunction are discussed separately. […] Epidemiology and prognosis of monosymptomatic enuresis.

• #3 Bed-wetting in US children: epidemiology and related behavior problems – PubMed

  https://pubmed.ncbi.nlm.nih.gov/8784366/

  Objective: To better understand the epidemiology and behavioral correlates of bed-wetting in a nationally representative sample of children. […] Results: Bed-wetting was reported in 33% of 5-, 18% of 8-, 7% of 11-, and 0.7% of 17-years-olds. At all ages, infrequent bed-wetting (fewer than six episodes per year) accounted for half of all reported bed-wetting. Lower age, male gender, and extreme scores on the BPI all were independently associated with both infrequent and frequent bed-wetting. […] Conclusions: Bed-wetting in children aged 5 years and older, irrespective of its frequency, is associated with increased rates of behavior problems. Thus, although infrequent bed-wetting may not warrant medical intervention, this condition should prompt health care providers to explore behavioral issues in greater depth.

• #4 Epidemiology of enuresis: a large number of children at risk of low regard | Italian Journal of Pediatrics | Full Text

  https://ijponline.biomedcentral.com/articles/10.1186/s13052-020-00896-3

  To describe the epidemiological aspects of nocturnal enuresis (NE). In this study we identify the prevalence and the familial conditions in a large, representative sample of children with monosymptomatic NE (MNE) and nonmonosyptomatic NE (NMNE). […] The prevalence of NE is variable. It is above 10% among 6year-old, around 5% among 10year-old, and 0.51% among teenagers and young adults. […] Despite the high prevalence of NE, doctors in a primary care setting may have difficulty in the evaluation and management of this condition. […] In this study we aimed to describe the different epidemiological aspects of NE in children from Italy analysing prevalence and type of NE, comorbidity, therapeutic choices, pharmacological and psychological/behavioural interventions, dietary associated factors in samples collected from Italian Pediatricians.

• #5 Enuresis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1014762-overview

  In the United States, the prevalence of PE varies by age. At age 4 years, 25% of children frequently wet the bed, but by age 7 years, only 5-10% still wet the bed, and by age 10 years, fewer than 5% of children do so. […] The resolution rate of PE is approximately 15% per year; by the late teenaged years, very few patients have the condition. The resolution rate is often used as a justification for waiting and not treating PE. However, it probably is not applicable to children who wet every night and likely applies only to those children who have already started to have dry nights. […] Worldwide, the prevalence of PE seems to be approximately the same, though no standardized evaluation of the prevalence of bedwetting has been made on a global basis. […] The prevalence of enuresis gradually declines during childhood. Of children aged 5 years, 23% have enuresis. During elementary school years, 10% of 7-year-old children and 4% of 10-year-old children still experience enuresis. In adults, however, the reported prevalence of enuresis is 0.5-2%. A Korean epidemiologic study found that the overall prevalence of nocturnal enuresis in subjects aged 16-40 years was 2.6%.

• #6

  https://journals.lww.com/smj/fulltext/2024/04000/approach_to_nocturnal_enuresis_in_children.8.aspx

  Nocturnal enuresis (NE) is a common condition seen in children aged 5 years and is defined by the occurrence of intermittent incontinence during sleep, at least once a month for a minimum duration of 3 months. […] The estimated prevalence of NE at 5 years of age is approximately 15%. Without treatment, NE typically resolves spontaneously at a rate of 15% per year with persistence at higher ages. The prevalence among teenagers is around 3% and in adults, it is 0.5%1%. […] Enuresis seems to be twice more common in boys, in whom the problem is often more difficult to treat. […] Primary enuresis is also twice more common than secondary enuresis. […] Of note, less than 3% of children referred to enuresis clinic have an identifiable organic cause. Such organic causes must be evaluated if history suggests their presence.

• #7 Epidemiology – GPnotebook

  https://gpnotebook.com/pages/infectious-disease/enuresis/epidemiology

  Nocturnal enuresis (bedwetting) is common among school-aged children. […] More common in boys than girls at all ages. […] Around one in six 5-year-olds, and at least one in fifty 7-year-old boys and one in a hundred 7-year-old girls, have nocturnal enuresis (wetting the bed) more than once a week. […] Owing to the differences in definitions and methods of diagnosis, the exact prevalence of bedwetting is unknown. In UK, prevalence decreases with age: in 5 year olds – 15 to 20% wet the bed on average twice a week, in 7 year olds – 7%, in 10 year olds – 5%, between 12 to 14 year olds – 2% to 3%, those aged 15 and over – 1% to 2%. […] NICE state that bedwetting (nocturnal enuresis) less than 2 nights a week has a prevalence of 21% at about 4 and a half years and 8% at 9 and a half years. More frequent bedwetting (more than 2 nights per week) is less common and has a prevalence of 8% at 4 and a half years and 1.5% at 9 and a half years.

• #8 Bed-wetting in US children: epidemiology and related behavior problems – PubMed

  https://pubmed.ncbi.nlm.nih.gov/8784366/

  Objective: To better understand the epidemiology and behavioral correlates of bed-wetting in a nationally representative sample of children. […] Results: Bed-wetting was reported in 33% of 5-, 18% of 8-, 7% of 11-, and 0.7% of 17-years-olds. At all ages, infrequent bed-wetting (fewer than six episodes per year) accounted for half of all reported bed-wetting. Lower age, male gender, and extreme scores on the BPI all were independently associated with both infrequent and frequent bed-wetting. […] Conclusions: Bed-wetting in children aged 5 years and older, irrespective of its frequency, is associated with increased rates of behavior problems. Thus, although infrequent bed-wetting may not warrant medical intervention, this condition should prompt health care providers to explore behavioral issues in greater depth.

• #9 Nocturnal enuresis – Wikipedia

  https://en.wikipedia.org/wiki/Nocturnal_enuresis

  Bedwetting is the most common childhood complaint. […] Doctors frequently consider bedwetting as a self-limiting problem, since most children will outgrow it. Children 5 to 9 years old have a spontaneous cure rate of 14% per year. Adolescents 10 to 17 years old have a spontaneous cure rate of 16% per year. […] As can be seen from the numbers above, a portion of bedwetting children will not outgrow the problem. Adult rates of bedwetting show little change due to spontaneous cure. Persons who are still enuretic at age 17 are likely to deal with bedwetting throughout their lives. […] Studies of bedwetting in adults have found varying rates. The most quoted study in this area was done in the Netherlands. It found a 0.5% rate for 20- to 79-year-olds. A Hong Kong study, however, found a much higher rate. The Hong Kong researchers found a bedwetting rate of 2.3% in 16- to 40-year-olds.

• #10 Bedwetting (enuresis) Statistics and Epidemiology

  http://www.dryatnight.com/bedwetting-stats.htm

  Your child has only a 15% chance of „growing out” of wetting the bed this year. […] Numerous epidemiological studies have provided insight into how common nocturnal enuresis is among children throughout the world. […] How prevalent is bedwetting? A number of epidemiological studies have been conducted internationally to identify how many children wet the bed and the results vary widely. […] The spontaneous remission rate for enuresis is estimated to be approximately 15% per year. In other words, without any intervention, only 15% of bedwetting children will become dry each year. Unfortunately, the vast majority (i.e., 85%) will still be wetting the bed a year from now if parents, or their pediatricians, choose not to intervene with treatment.

• #11 Bedwetting (enuresis) Statistics and Epidemiology

  http://www.dryatnight.com/bedwetting-stats.htm

  Your child has only a 15% chance of „growing out” of wetting the bed this year. […] Numerous epidemiological studies have provided insight into how common nocturnal enuresis is among children throughout the world. […] How prevalent is bedwetting? A number of epidemiological studies have been conducted internationally to identify how many children wet the bed and the results vary widely. […] The spontaneous remission rate for enuresis is estimated to be approximately 15% per year. In other words, without any intervention, only 15% of bedwetting children will become dry each year. Unfortunately, the vast majority (i.e., 85%) will still be wetting the bed a year from now if parents, or their pediatricians, choose not to intervene with treatment.

• #12 Enuresis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1014762-overview

  In the United States, the prevalence of PE varies by age. At age 4 years, 25% of children frequently wet the bed, but by age 7 years, only 5-10% still wet the bed, and by age 10 years, fewer than 5% of children do so. […] The resolution rate of PE is approximately 15% per year; by the late teenaged years, very few patients have the condition. The resolution rate is often used as a justification for waiting and not treating PE. However, it probably is not applicable to children who wet every night and likely applies only to those children who have already started to have dry nights. […] Worldwide, the prevalence of PE seems to be approximately the same, though no standardized evaluation of the prevalence of bedwetting has been made on a global basis. […] The prevalence of enuresis gradually declines during childhood. Of children aged 5 years, 23% have enuresis. During elementary school years, 10% of 7-year-old children and 4% of 10-year-old children still experience enuresis. In adults, however, the reported prevalence of enuresis is 0.5-2%. A Korean epidemiologic study found that the overall prevalence of nocturnal enuresis in subjects aged 16-40 years was 2.6%.

• #13 Enuresis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1014762-overview

  When PE and SE are reported, a secondary onset accounts for about 25% of cases. The prevalence of SE as a percentage of all cases increases with age. In a cohort of New Zealand children, 7.9% developed SE by the age of 10 years. […] Enuresis is more common in males. The reported prevalences of enuresis at the ages of 7 and 10 years are 9% and 7%, respectively, in boys and 6% and 3%, respectively, in girls. No racial predisposition has been documented.

• #14 Nocturnal Enuresis in Children (Bed Wetting) | Doctor

  https://patient.info/doctor/nocturnal-enuresis-in-children

  Nocturnal enuresis (bedwetting) is defined by the National Institute for Health and Care Excellence (NICE) guidelines as the involuntary wetting during sleep – without any inherent suggestion of frequency of bedwetting or pathophysiology. It is considered normal up to the age of 5 years, and is common up to the age of 10 years. […] Prevalence is reported as follows: 5-10% of 7-year-olds. 1-2% of adolescents (15 years and older). 0.5-1.0% of adults. More prevalent in boys – 2:1 ratio, although the difference disappears after age 10. […] There are a number of factors that predispose to persistent nocturnal enuresis. More likely to persist if bedwetting is frequent. Family history. Strong association with parental history of enuresis. […] The majority of children who do not have a serious neurological defect or severe learning difficulties can expect to achieve nocturnal continence sooner or later. Primary enuresis without daytime symptoms resolves in approximately 5-10% of children each year.

• #15 Nocturnal Enuresis in Children (Bed Wetting) | Doctor

  https://patient.info/doctor/nocturnal-enuresis-in-children

  Nocturnal enuresis (bedwetting) is defined by the National Institute for Health and Care Excellence (NICE) guidelines as the involuntary wetting during sleep – without any inherent suggestion of frequency of bedwetting or pathophysiology. It is considered normal up to the age of 5 years, and is common up to the age of 10 years. […] Prevalence is reported as follows: 5-10% of 7-year-olds. 1-2% of adolescents (15 years and older). 0.5-1.0% of adults. More prevalent in boys – 2:1 ratio, although the difference disappears after age 10. […] There are a number of factors that predispose to persistent nocturnal enuresis. More likely to persist if bedwetting is frequent. Family history. Strong association with parental history of enuresis. […] The majority of children who do not have a serious neurological defect or severe learning difficulties can expect to achieve nocturnal continence sooner or later. Primary enuresis without daytime symptoms resolves in approximately 5-10% of children each year.

• #16 Nocturnal enuresis in children | PPT

  https://www.slideshare.net/slideshow/nocturnal-enuresis-in-children/251477926

  Enuresis (Bed-Wetting) Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 yr of age. Diurnal enuresis defines wetting while awake and nocturnal enuresis refers to voiding during sleep. Primary enuresis occurs in children who have never been consistently dry through the night, whereas secondary enuresis refers to the resumption of wetting after at least 6 months of dryness. […] Epidemiology Prevalence estimates vary significantly. At age 5 yr, 7% of boys and 3% of girls have enuresis; by age 10 yr the percentages are 3% and 2%, respectively: by age 18 yr, 1% for men and less than 1% for women. Primary enuresis accounts for 85% of cases. Enuresis is more common in lower socioeconomic groups, in larger families, and in institutionalized children. There is an estimated spontaneous cure rate of 14-16% annually. Diurnal enuresis is more common in girls and rarely occurs after the age of 9 yr.

• #17 Global prevalence of nocturnal enuresis and associated factors among children and adolescents: a systematic review and meta-analysis | Child and Adolescent Psychiatry and Mental Health | Full Text

  https://capmh.biomedcentral.com/articles/10.1186/s13034-025-00880-x

  The pooled odds ratio indicates that male children and adolescents are approximately 1.63 times more likely to develop NE compared to their female counterparts, with an AOR of 1.63 (95% CI: 1.311.94). […] The forest plot result of the studies showed that the overall effect size was AOR 0.5 (95% CI: 0.370.62).

• #18 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20210119/Study-finds-genetic-variants-that-increase-the-risk-of-bedwetting.aspx

  In a large-scale study of Danish children and young people, researchers from Aarhus University have for the first time found genetic variants that increase the risk of nocturnal enuresis – commonly known as bedwetting or nighttime incontinence. […] Researchers have long known that nighttime incontinence is a highly heritable condition. […] In collaboration with the Danish research project iPSYCH and a team of international colleagues, researchers from Aarhus University have for the first time identified genetic variants that increase the risk of bedwetting. […] As many as sixteen per cent of all seven-year-olds suffer from nocturnal enuresis and although many of them grow out of it, one to two per cent of all young adults still have this problem. […] The study also shows that commonly occurring genetic variants can explain up to one-third of the genetic risk of bedwetting.

• #19 Practical solutions to help parents deal with childhood bedwetting | Nursing Times

  https://www.nursingtimes.net/archive/practical-solutions-to-help-parents-deal-with-childhood-bedwetting-01-10-2001/

  Bedwetting is the most prevalent of chronic childhood disorders (Hicks and Clark, 1999), and families who are affected may feel isolated and stigmatised. This article discusses the nature of bedwetting – including definitions and epidemiology – treatment strategies and the role of the health visitor and practice nurse in managing this problem. […] Nocturnal enuresis affects at least 500,000 children between the ages of five and 11 in the UK each year. The prevalence of the condition among the entire child population is broken down in Box 1. […] Genetics – Research has revealed a strong genetic link in cases of enuresis (vonGontard, 1999). […] The problem of bedwetting is often overlooked or ignored, yet it can cause the child great and unnecessary embarrassment. There is often a solution, and the practice nurse or health visitor is often the first health professional the family will speak to for advice on the matter.

• #20 Nocturnal Enuresis | PPT

  https://www.slideshare.net/slideshow/nocturnal-enuresis-91654488/91654488

  The cause of enuresis likely involves biologic, emotional, and learning factors. Compared with a 15% incidence of enuresis in children from nonenuretic families, 44% and 77% of children were enuretic when one or both parents, respectively, were themselves enuretic. Linkage studies have implicated several chromosomes with varying patterns of transmission. […] Children with nocturnal enuresis might hyposecrete arginine vasopressin (AVP) and may be less responsive to the lower urine osmolality associated with fluid loading. Many affected children also appear to have small functional bladder capacity. There is some support for a relationship among sleep architecture, diminished capacity to be aroused from sleep, and abnormal bladder function. Psychosocial stressors may be contributory. […] Given the steady progression in the spontaneous remission rate of enuresis each year, there is some question as to whether enuresis should be treated. Family conflict, parent-child antagonism, and/or peer teasing due to the enuresis are good reasons to institute treatment for enuresis with resultant beneficial effects on a child’s well-being and self-esteem.

• #21 4. Bedwetting and toileting problems in children | The Medical Journal of Australia

  https://www.mja.com.au/journal/2005/182/4/4-bedwetting-and-toileting-problems-children

  Bedwetting (nocturnal enuresis) is common. It occurs in up to 20% of 5 year olds and 10% of 10 year olds, with a spontaneous remission rate of 14% per year. Weekly daytime wetting occurs in 5% of children, most of whom (80%) also wet the bed. […] Bedwetting occurs in up to 20% of school-aged children, with 2.4% wetting at least nightly. The prevalence is about 20% in 5 year olds, 10% in 10 year olds and 3% in 15 year olds. Children tend to outgrow bedwetting, with a spontaneous remission rate of about 14% annually among bedwetters (with 3% remaining enuretic as adults). […] The aetiology of bedwetting is multifactorial, with a complex interaction of genetic and environmental factors. It is important to distinguish the different forms of enuresis, as aetiology and management differ. […] Primary nocturnal enuresis: Important risk factors include family history, nocturnal polyuria, impaired sleep arousal and nocturnal bladder dysfunction. Bedwetting has been linked to chromosomes 13, 12, 8 and 22, with a predominantly autosomal dominant inheritance.

• #22 Global prevalence of nocturnal enuresis and associated factors among children and adolescents: a systematic review and meta-analysis | Child and Adolescent Psychiatry and Mental Health | Full Text

  https://capmh.biomedcentral.com/articles/10.1186/s13034-025-00880-x

  The prevalence of Nocturnal enuresis among 127 individual studies ranged from 1.276.4%, with a pooled prevalence of 7.2% (95% CI: 6.28.1%). […] The pooled odds ratio indicates that children and adolescents with a family history of NE are nearly 1.5 times more likely to develop the condition compared to their counterparts without such a history, with an AOR of 1.49 (95% CI: 1.261.71). […] The pooled odds ratio indicates that children and adolescents with a history of UTIs are nearly four times more likely to develop NE compared to those without a history of such infections, with an AOR of 3.89 (95% CI: 2.934.46). […] The pooled odds ratio indicates that children and adolescents who have experienced stressful events are nearly twice as likely to develop NE compared to those without such a history, with an adjusted odds ratio (AOR) of 1.90 (95% CI: 1.752.05).

• #23 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20210119/Study-finds-genetic-variants-that-increase-the-risk-of-bedwetting.aspx

  In a large-scale study of Danish children and young people, researchers from Aarhus University have for the first time found genetic variants that increase the risk of nocturnal enuresis – commonly known as bedwetting or nighttime incontinence. […] Researchers have long known that nighttime incontinence is a highly heritable condition. […] In collaboration with the Danish research project iPSYCH and a team of international colleagues, researchers from Aarhus University have for the first time identified genetic variants that increase the risk of bedwetting. […] As many as sixteen per cent of all seven-year-olds suffer from nocturnal enuresis and although many of them grow out of it, one to two per cent of all young adults still have this problem. […] The study also shows that commonly occurring genetic variants can explain up to one-third of the genetic risk of bedwetting.

• #24 Epidemiology of nocturnal enuresis among primary school children (6-12 years) in Gharbia Governorate. – Document – Gale OneFile: Health and Medicine

  https://go.gale.com/ps/i.do?id=GALE%7CA619064490&sid=googleScholar&v=2.1&it=r&linkaccess=fulltext&issn=11102098&p=HRCA&sw=w

  Objective The aim of this study was to determine the prevalence of nocturnal enuresis (NE) and identify its risk factors among primary school children (6-12 years) in Gharbia Governorate. […] Large epidemiological studies suggested the prevalence rates of 15-20% among children 5 years and older. […] The prevalence of NE was 14.3%. The prevalence was slightly higher among boys than girls, with 14.8 and 13.9%, respectively, and it was more common among rural children than urban ones, with 19.1 and 7.5%, respectively. […] Primary enuresis more than secondary, low socioeconomic standard, low educational level of parents, and family history of NE were the contributing factors of NE among studied children. […] Enuresis is a pediatric public health problem that is often associated with young age. […] Several factors have been associated with an increased risk of bed-wetting including younger age, male sex, Black race, history of urinary tract infection, and a family history of enuresis. […] However, low socioeconomic status is not consistently associated with enuresis.

• #25 Nocturnal enuresis in children | PPT

  https://www.slideshare.net/slideshow/nocturnal-enuresis-in-children/251477926

  Enuresis (Bed-Wetting) Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 yr of age. Diurnal enuresis defines wetting while awake and nocturnal enuresis refers to voiding during sleep. Primary enuresis occurs in children who have never been consistently dry through the night, whereas secondary enuresis refers to the resumption of wetting after at least 6 months of dryness. […] Epidemiology Prevalence estimates vary significantly. At age 5 yr, 7% of boys and 3% of girls have enuresis; by age 10 yr the percentages are 3% and 2%, respectively: by age 18 yr, 1% for men and less than 1% for women. Primary enuresis accounts for 85% of cases. Enuresis is more common in lower socioeconomic groups, in larger families, and in institutionalized children. There is an estimated spontaneous cure rate of 14-16% annually. Diurnal enuresis is more common in girls and rarely occurs after the age of 9 yr.

• #26 Epidemiology of nocturnal enuresis among primary school children (6-12 years) in Gharbia Governorate. – Document – Gale OneFile: Health and Medicine

  https://go.gale.com/ps/i.do?id=GALE%7CA619064490&sid=googleScholar&v=2.1&it=r&linkaccess=fulltext&issn=11102098&p=HRCA&sw=w

  Objective The aim of this study was to determine the prevalence of nocturnal enuresis (NE) and identify its risk factors among primary school children (6-12 years) in Gharbia Governorate. […] Large epidemiological studies suggested the prevalence rates of 15-20% among children 5 years and older. […] The prevalence of NE was 14.3%. The prevalence was slightly higher among boys than girls, with 14.8 and 13.9%, respectively, and it was more common among rural children than urban ones, with 19.1 and 7.5%, respectively. […] Primary enuresis more than secondary, low socioeconomic standard, low educational level of parents, and family history of NE were the contributing factors of NE among studied children. […] Enuresis is a pediatric public health problem that is often associated with young age. […] Several factors have been associated with an increased risk of bed-wetting including younger age, male sex, Black race, history of urinary tract infection, and a family history of enuresis. […] However, low socioeconomic status is not consistently associated with enuresis.

• #27 Enuresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545181/

  Enuresis, commonly known as bedwetting, is a prevalent pediatric condition affecting approximately 15% of 5-year-old children. […] The prevalence of enuresis is similar across cultures and varies with age, with males affected twice as often as females. By age 4, nearly 25% of children experience frequent bedwetting; by 5, the condition affects approximately 15% of children. Once children reach 8, the incidence is 4%. However, due to the stigma associated with enuresis, many cases go unreported, making the true prevalence challenging to ascertain. […] The International Children’s Continence Society reports that 20% to 30% of children with enuresis have at least 1 mental health condition, approximately twice the rate of non-wetting children. The most frequently cited disorder accompanying enuresis is attention deficit hyperactivity disorder, but others include autism spectrum disorder, oppositional defiant disorder, and mood disorders. This link is an association, not proof of causation since enuresis can result in feelings of shame, embarrassment, and frustration, which then lead to anxiety and depression.

• #28 Enuresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545181/

  Enuresis, commonly known as bedwetting, is a prevalent pediatric condition affecting approximately 15% of 5-year-old children. […] The prevalence of enuresis is similar across cultures and varies with age, with males affected twice as often as females. By age 4, nearly 25% of children experience frequent bedwetting; by 5, the condition affects approximately 15% of children. Once children reach 8, the incidence is 4%. However, due to the stigma associated with enuresis, many cases go unreported, making the true prevalence challenging to ascertain. […] The International Children’s Continence Society reports that 20% to 30% of children with enuresis have at least 1 mental health condition, approximately twice the rate of non-wetting children. The most frequently cited disorder accompanying enuresis is attention deficit hyperactivity disorder, but others include autism spectrum disorder, oppositional defiant disorder, and mood disorders. This link is an association, not proof of causation since enuresis can result in feelings of shame, embarrassment, and frustration, which then lead to anxiety and depression.

• #29 Urine metabolic phenotyping in children with nocturnal enuresis and comorbid neurobehavioral disorders | Scientific Reports

  https://www.nature.com/articles/s41598-021-96104-1

  Nocturnal enuresis (NE) is a common problem among 10% school-aged children. […] The literatures reported the prevalence of childhood NE is highly variable among different countries, ranging from 2.3 to 25%. […] In Taiwan, there was 6.8% of elementary-school children reported to have the bedwetting problem. […] Overall, the global prevalence of NE is around 10% among school-aged children, particularly predominance in boys. […] Notably, if bedwetting children and adolescents are not treated properly or ignored without treatment, there is 2% of the population persistent into adulthood. […] However, 40% of bedwetting children and adolescents still have insufficient responses to the standard treatment or experience a relapse after stopping treatment, particularly for those with NMNE. […] The prevalence estimates of enuresis in children with ADHD have been reported in 22-32%.

• #30 Urine metabolic phenotyping in children with nocturnal enuresis and comorbid neurobehavioral disorders | Scientific Reports

  https://www.nature.com/articles/s41598-021-96104-1

  On the other hand, 30-40% of bedwetting children ages six to 12 years had a diagnosis of different types of ADHD. […] This bidirectional relationship between the two disorders is potentially explained by deficits in arousal and/or developmental delays in central nervous system. […] The KEGG pathway analysis revealed the changes of urinary betaine, creatine and guanidinoacetate concentrations involved in glycine, serine and threonine metabolism appeared to have statistically significant relations to a comorbidity of ADHD or anxiety in persistent bedwetting children. […] More than half of children affected by the two disorders were resistant to the standard medications and presented frequent NE (three episodes per week).

• #31 Urine metabolic phenotyping in children with nocturnal enuresis and comorbid neurobehavioral disorders | Scientific Reports

  https://www.nature.com/articles/s41598-021-96104-1

  On the other hand, 30-40% of bedwetting children ages six to 12 years had a diagnosis of different types of ADHD. […] This bidirectional relationship between the two disorders is potentially explained by deficits in arousal and/or developmental delays in central nervous system. […] The KEGG pathway analysis revealed the changes of urinary betaine, creatine and guanidinoacetate concentrations involved in glycine, serine and threonine metabolism appeared to have statistically significant relations to a comorbidity of ADHD or anxiety in persistent bedwetting children. […] More than half of children affected by the two disorders were resistant to the standard medications and presented frequent NE (three episodes per week).

• #32 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20210119/Study-finds-genetic-variants-that-increase-the-risk-of-bedwetting.aspx

  The study also shows that children with many genetic variants that increase the risk of ADHD are particularly vulnerable to developing bedwetting. […] As the study is a first-time study, the researchers also examined more than 5,500 people from Iceland, where they found that the same genetic variants also appear to increase the risk of nocturnal enuresis. […] The researchers hope to be able to further clarify the causes of nocturnal enuresis. […] At present we still can’t use a child’s genetic profile to predict, for example, whether the child will grow out of its condition or whether a particular treatment works.

• #33 4. Bedwetting and toileting problems in children | The Medical Journal of Australia

  https://www.mja.com.au/journal/2005/182/4/4-bedwetting-and-toileting-problems-children

  Bedwetting (nocturnal enuresis) is common. It occurs in up to 20% of 5 year olds and 10% of 10 year olds, with a spontaneous remission rate of 14% per year. Weekly daytime wetting occurs in 5% of children, most of whom (80%) also wet the bed. […] Bedwetting occurs in up to 20% of school-aged children, with 2.4% wetting at least nightly. The prevalence is about 20% in 5 year olds, 10% in 10 year olds and 3% in 15 year olds. Children tend to outgrow bedwetting, with a spontaneous remission rate of about 14% annually among bedwetters (with 3% remaining enuretic as adults). […] The aetiology of bedwetting is multifactorial, with a complex interaction of genetic and environmental factors. It is important to distinguish the different forms of enuresis, as aetiology and management differ. […] Primary nocturnal enuresis: Important risk factors include family history, nocturnal polyuria, impaired sleep arousal and nocturnal bladder dysfunction. Bedwetting has been linked to chromosomes 13, 12, 8 and 22, with a predominantly autosomal dominant inheritance.

• #34 4. Bedwetting and toileting problems in children | The Medical Journal of Australia

  https://www.mja.com.au/journal/2005/182/4/4-bedwetting-and-toileting-problems-children

  Secondary nocturnal enuresis: Risk factors include urinary tract infections (which may cause temporary detrusor and/or urethral instability), diabetes mellitus and diabetes insipidus, stress, sexual abuse and other psychopathological conditions, as well as some of the risk factors for primary nocturnal enuresis, such as constipation and upper-airway obstruction. […] Daytime urinary incontinence of mild severity (at least once in the past 6 months) occurs in up to 20% of school-aged children, with 2.0% wetting twice or more per week and 0.7% wetting every day.

• #35 Nocturnal enuresis in children | PPT

  https://www.slideshare.net/slideshow/nocturnal-enuresis-in-children/251477926

  Enuresis (Bed-Wetting) Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 yr of age. Diurnal enuresis defines wetting while awake and nocturnal enuresis refers to voiding during sleep. Primary enuresis occurs in children who have never been consistently dry through the night, whereas secondary enuresis refers to the resumption of wetting after at least 6 months of dryness. […] Epidemiology Prevalence estimates vary significantly. At age 5 yr, 7% of boys and 3% of girls have enuresis; by age 10 yr the percentages are 3% and 2%, respectively: by age 18 yr, 1% for men and less than 1% for women. Primary enuresis accounts for 85% of cases. Enuresis is more common in lower socioeconomic groups, in larger families, and in institutionalized children. There is an estimated spontaneous cure rate of 14-16% annually. Diurnal enuresis is more common in girls and rarely occurs after the age of 9 yr.

• #36

  https://journals.lww.com/smj/fulltext/2024/04000/approach_to_nocturnal_enuresis_in_children.8.aspx

  Nocturnal enuresis (NE) is a common condition seen in children aged 5 years and is defined by the occurrence of intermittent incontinence during sleep, at least once a month for a minimum duration of 3 months. […] The estimated prevalence of NE at 5 years of age is approximately 15%. Without treatment, NE typically resolves spontaneously at a rate of 15% per year with persistence at higher ages. The prevalence among teenagers is around 3% and in adults, it is 0.5%1%. […] Enuresis seems to be twice more common in boys, in whom the problem is often more difficult to treat. […] Primary enuresis is also twice more common than secondary enuresis. […] Of note, less than 3% of children referred to enuresis clinic have an identifiable organic cause. Such organic causes must be evaluated if history suggests their presence.

• #37 Enuresis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1014762-overview

  When PE and SE are reported, a secondary onset accounts for about 25% of cases. The prevalence of SE as a percentage of all cases increases with age. In a cohort of New Zealand children, 7.9% developed SE by the age of 10 years. […] Enuresis is more common in males. The reported prevalences of enuresis at the ages of 7 and 10 years are 9% and 7%, respectively, in boys and 6% and 3%, respectively, in girls. No racial predisposition has been documented.

• #38 Enuresis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1014762-overview

  When PE and SE are reported, a secondary onset accounts for about 25% of cases. The prevalence of SE as a percentage of all cases increases with age. In a cohort of New Zealand children, 7.9% developed SE by the age of 10 years. […] Enuresis is more common in males. The reported prevalences of enuresis at the ages of 7 and 10 years are 9% and 7%, respectively, in boys and 6% and 3%, respectively, in girls. No racial predisposition has been documented.

• #39

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Nocturnal-Enuresis-in-Teens.aspx

  Nocturnal enuresis, defined as nighttime bedwetting beyond age 5, affects many school-age children and even some teens. It’s not a serious health problem, and children usually outgrow it. Still, bedwetting can be upsetting for children and parents. […] Around 20% of children have some problems with bedwetting at age 5, and up to 10% still do at age 7. By the late teens, the estimated rate of bedwetting is between 1% and 3% of children. Nocturnal enuresis is 2 to 3 times more common in boys than girls. […] Primary enuresis is much more common. Secondary enuresis in older children or teens should be evaluated by a doctor. Bedwetting in this age group could be a sign of a urinary tract infection or other health problems, neurological issues (related to the brain), stress, or other issues.

• #40 Epidemiology of enuresis: a large number of children at risk of low regard | Italian Journal of Pediatrics | Full Text

  https://ijponline.biomedcentral.com/articles/10.1186/s13052-020-00896-3

  Our findings suggest that NE affect a significant number of children and adolescents but it is still underestimated. Over 130,000 children analyzed by questionnaires, the prevalence of NE was 7.1% and only 25% of this population suffer from MNE. […] NE is often associated with specific comorbidities, such as urinary tract infections and fecal incontinence with or without constipation, especially in NMNE. […] A large percentage of parents declared to use or to have used alternative therapies and not to prefer, at first, a pharmacological intervention; this data is found in the literature too, where systematic reviews are presented to declare the possible effectiveness and safety of the following alternative interventions such as homotoxicology, acupuncture, dry bed training, enuresis alarm, and hypnotherapy. […] NE is a very common disorders with high prevalence in Italy and a deep impact on children and families quality of life.

• #41 Epidemiology of enuresis: a large number of children at risk of low regard | Italian Journal of Pediatrics | Full Text

  https://ijponline.biomedcentral.com/articles/10.1186/s13052-020-00896-3

  Our findings suggest that NE affect a significant number of children and adolescents but it is still underestimated. Over 130,000 children analyzed by questionnaires, the prevalence of NE was 7.1% and only 25% of this population suffer from MNE. […] NE is often associated with specific comorbidities, such as urinary tract infections and fecal incontinence with or without constipation, especially in NMNE. […] A large percentage of parents declared to use or to have used alternative therapies and not to prefer, at first, a pharmacological intervention; this data is found in the literature too, where systematic reviews are presented to declare the possible effectiveness and safety of the following alternative interventions such as homotoxicology, acupuncture, dry bed training, enuresis alarm, and hypnotherapy. […] NE is a very common disorders with high prevalence in Italy and a deep impact on children and families quality of life.

• #42 Evaluation and management of enuresis in the general paediatric setting | Canadian Paediatric Society

  https://cps.ca/en/documents/position/evaluation-and-management-of-enuresis-in-the-general-paediatric-setting

  Enuresis, or bedwetting, is defined as discrete episodes of urinary incontinence during sleep in children aged 5 and older, and is commonly encountered in paediatric practice. […] The prevalence is 15% at age 5 years, 10% by age 7, and 5% by age 10. […] Untreated enuresis has an estimated prevalence into adulthood of up to 2%. […] Enuresis can have significant negative impacts on child health and family life. […] Distinguishing monosymptomatic from non-monosymptomatic enuresis requires active screening. […] Mild daytime lower urinary tract symptoms (LUTS) are common, affecting up to two-thirds of enuretic children. […] Improvement in LUTS can improve enuresis secondarily. […] Enuresis treatment is less likely to succeed in the presence of unrecognized and untreated LUTS. […] Numerous studies have underlined the connections between obstructive sleep apnea (OSA) and enuresis, possibly related to sleep arousal.

• #43 4. Bedwetting and toileting problems in children | The Medical Journal of Australia

  https://www.mja.com.au/journal/2005/182/4/4-bedwetting-and-toileting-problems-children

  Bedwetting (nocturnal enuresis) is common. It occurs in up to 20% of 5 year olds and 10% of 10 year olds, with a spontaneous remission rate of 14% per year. Weekly daytime wetting occurs in 5% of children, most of whom (80%) also wet the bed. […] Bedwetting occurs in up to 20% of school-aged children, with 2.4% wetting at least nightly. The prevalence is about 20% in 5 year olds, 10% in 10 year olds and 3% in 15 year olds. Children tend to outgrow bedwetting, with a spontaneous remission rate of about 14% annually among bedwetters (with 3% remaining enuretic as adults). […] The aetiology of bedwetting is multifactorial, with a complex interaction of genetic and environmental factors. It is important to distinguish the different forms of enuresis, as aetiology and management differ. […] Primary nocturnal enuresis: Important risk factors include family history, nocturnal polyuria, impaired sleep arousal and nocturnal bladder dysfunction. Bedwetting has been linked to chromosomes 13, 12, 8 and 22, with a predominantly autosomal dominant inheritance.

• #44 Enuresis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1014762-overview

  In the United States, the prevalence of PE varies by age. At age 4 years, 25% of children frequently wet the bed, but by age 7 years, only 5-10% still wet the bed, and by age 10 years, fewer than 5% of children do so. […] The resolution rate of PE is approximately 15% per year; by the late teenaged years, very few patients have the condition. The resolution rate is often used as a justification for waiting and not treating PE. However, it probably is not applicable to children who wet every night and likely applies only to those children who have already started to have dry nights. […] Worldwide, the prevalence of PE seems to be approximately the same, though no standardized evaluation of the prevalence of bedwetting has been made on a global basis. […] The prevalence of enuresis gradually declines during childhood. Of children aged 5 years, 23% have enuresis. During elementary school years, 10% of 7-year-old children and 4% of 10-year-old children still experience enuresis. In adults, however, the reported prevalence of enuresis is 0.5-2%. A Korean epidemiologic study found that the overall prevalence of nocturnal enuresis in subjects aged 16-40 years was 2.6%.

• #45 Bed-wetting (nocturnal enuresis) in children

  https://parentingscience.com/bed-wetting/

  Is bed-wetting in children — also known as “sleep enuresis” — a sign of illness? Does it indicate a child is lazy or defiant? Trying to get attention? Suffering from behavior problems? […] The answer — in most cases — is no. […] Studies suggest that most young children stop wetting the bed between the ages of 4 and 5. […] One reasonable guess is that approximately 15-20% of kids in the early grades of primary school — 6- and 7-year olds — still wet the bed from time to time. […] Bed-wetting has been documented all over the world — in Africa, the Americas, Asia, Australia, Europe, and the Middle East. […] Researchers recognize a number of possible causes. The most common include: reduced bladder capacity, and/or an overactive bladder; too much urine production at night; failure to awaken in response to the sensation of a full bladder; urinary tract infection; constipation; obstructive sleep apnea.

• #46 Global prevalence of nocturnal enuresis and associated factors among children and adolescents: a systematic review and meta-analysis | Child and Adolescent Psychiatry and Mental Health | Full Text

  https://capmh.biomedcentral.com/articles/10.1186/s13034-025-00880-x

  Nocturnal enuresis (NE), a prevalent childhood condition associated with significant emotional morbidity, including anxiety, guilt, and diminished self-esteem. Notably, NE exhibits substantial variability in prevalence across diverse geographical and sociocultural contexts ranging from 2 to 75%, highlighting the influence of environmental and societal factors. […] The overall pooled prevalence of Nocturnal enuresis among children and adolescents was 7.2% (95% CI: 6.2-8.1%). […] The study found that nocturnal enuresis affects approximately 7.2% of children and adolescents. Family history, urinary tract infection, parental death, birth order, and sex were statistically significant factors. […] Understanding the factors that contribute to nocturnal enuresis is essential for effective management.

• #47 Global prevalence of nocturnal enuresis and associated factors among children and adolescents: a systematic review and meta-analysis | Child and Adolescent Psychiatry and Mental Health | Full Text

  https://capmh.biomedcentral.com/articles/10.1186/s13034-025-00880-x

  The prevalence of Nocturnal enuresis among 127 individual studies ranged from 1.276.4%, with a pooled prevalence of 7.2% (95% CI: 6.28.1%). […] The pooled odds ratio indicates that children and adolescents with a family history of NE are nearly 1.5 times more likely to develop the condition compared to their counterparts without such a history, with an AOR of 1.49 (95% CI: 1.261.71). […] The pooled odds ratio indicates that children and adolescents with a history of UTIs are nearly four times more likely to develop NE compared to those without a history of such infections, with an AOR of 3.89 (95% CI: 2.934.46). […] The pooled odds ratio indicates that children and adolescents who have experienced stressful events are nearly twice as likely to develop NE compared to those without such a history, with an adjusted odds ratio (AOR) of 1.90 (95% CI: 1.752.05).

• #48 Pattern and Risk Factors for Nocturnal Enuresis among Children in Aseer Region, Southwestern Saudi Arabia: A cross-sectional study | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.10.01.24314564v1.full-text

  Nocturnal enuresis is defined as persistent bed-wetting at night beyond the age of five year old. To assess the prevalence and risk factors for nocturnal enuresis in children of the Aseer region. The study included 466 children, of which 145 (31.1%) complained of recurrent bedwetting. More than half of the children who experienced nocturnal enuresis were males (58.6%), and 31.7% were aged between 7-8 years, with a mean age of 5.9 years. Attention-deficit hyperactivity disorder, dark phobia, family troubles, and exposure to bullying were the most frequently reported risk factors. Nearly 1 out of 3 children experienced bed-wetting, which is relatively common in boys than girls. Enuresis refers to the involuntary loss of urine during sleep that occurs at least twice a week in children older than 5 years of age (or the developmental equivalent) for at least 3 months, and it is the most common urologic complaint in pediatric patients. Nocturnal enuresis is 2-3 times more common in boys than girls. About 20% of all children report occasional instances of bed-wetting until the age of 5 years, and up to 10% still have problems by 7 years of age. Bed-wetting or enuresis is categorized as primary enuresis urinary incontinence in a child who has never been dry, and secondary enuresis incontinence in a child who has been dry for at least six months. Nocturnal enuresis in children is the second most reported pediatric problem after allergic diseases. Many causative factors have been associated with bed-wetting, such as developmental differences, including the development of a child’s urinary sphincters, and diseases like diabetes and urinary tract infections. Having a global incidence of 1.428% among 6-12 years old children, the condition is troublesome for the families of these children, as it can result in considerable emotional distress and psychological consequences. The study revealed that one-third of children in our study sample complained of bed-wetting. Notably, there was significant variability in the estimated prevalence of NE among children in Saudi Arabia, ranging from 12% to 75% according to the study setting and the sampled age groups. The estimated prevalence of nocturnal enuresis in different regions of Iran is reported as 8.25% to 8.8%, compared to other studies conducted in Hong Kong, China, and Thailand. The current study also revealed that nearly three-quarters of the children wet their bed between the age of 5-6 years, as many children have incomplete toilet training by this age and the immature nervous system is unable to fully control the bladder. Regarding the risk factors analyzed among the current study in the children resorting to bed-wetting, child-related stressors were reported in almost half of the sampled children; it included ADHD, which is a major risk factor detected in different studies, dark phobia, stress and anxiety, family troubles and parental separation, exposure to bullying, and physical abuse. We also observed that few children had a positive family history of nocturnal enuresis, one of the main risk factors, besides the water source, which was bottled water in nearly half of the sample.

• #49

  https://www.ijpediatrics.com/index.php/ijcp/article/view/2279

  Nocturnal enuresis or bedwetting is a common health problem in children in the age group of 5 to 15 years. In India the prevalence of nocturnal enuresis ranges from approximately 7% to 12.6%. The prevalence from other parts of the world ranges from 6% to 42%. […] The overall prevalence of nocturnal enuresis was 11.4 %. The maximum prevalence was found in the age group of 8 -9 years (22.96 %). The prevalence of nocturnal enuresis in boys (14.34 %) was significantly more than the prevalence in girls (8.31 %). […] The prevalence of nocturnal enuresis is 11.40 % in school going children and it is associated with age, sex, stress, family history, burning micturition, hyperactive child, poor school performance, sleep pattern (hard to awake) avoidance of going to micturate before sleep etc.

• #50 Urine metabolic phenotyping in children with nocturnal enuresis and comorbid neurobehavioral disorders | Scientific Reports

  https://www.nature.com/articles/s41598-021-96104-1

  Nocturnal enuresis (NE) is a common problem among 10% school-aged children. […] The literatures reported the prevalence of childhood NE is highly variable among different countries, ranging from 2.3 to 25%. […] In Taiwan, there was 6.8% of elementary-school children reported to have the bedwetting problem. […] Overall, the global prevalence of NE is around 10% among school-aged children, particularly predominance in boys. […] Notably, if bedwetting children and adolescents are not treated properly or ignored without treatment, there is 2% of the population persistent into adulthood. […] However, 40% of bedwetting children and adolescents still have insufficient responses to the standard treatment or experience a relapse after stopping treatment, particularly for those with NMNE. […] The prevalence estimates of enuresis in children with ADHD have been reported in 22-32%.

• #51 Pattern and Risk Factors for Nocturnal Enuresis among Children in Aseer Region, Southwestern Saudi Arabia: A cross-sectional study | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.10.01.24314564v1.full-text

  Nocturnal enuresis is defined as persistent bed-wetting at night beyond the age of five year old. To assess the prevalence and risk factors for nocturnal enuresis in children of the Aseer region. The study included 466 children, of which 145 (31.1%) complained of recurrent bedwetting. More than half of the children who experienced nocturnal enuresis were males (58.6%), and 31.7% were aged between 7-8 years, with a mean age of 5.9 years. Attention-deficit hyperactivity disorder, dark phobia, family troubles, and exposure to bullying were the most frequently reported risk factors. Nearly 1 out of 3 children experienced bed-wetting, which is relatively common in boys than girls. Enuresis refers to the involuntary loss of urine during sleep that occurs at least twice a week in children older than 5 years of age (or the developmental equivalent) for at least 3 months, and it is the most common urologic complaint in pediatric patients. Nocturnal enuresis is 2-3 times more common in boys than girls. About 20% of all children report occasional instances of bed-wetting until the age of 5 years, and up to 10% still have problems by 7 years of age. Bed-wetting or enuresis is categorized as primary enuresis urinary incontinence in a child who has never been dry, and secondary enuresis incontinence in a child who has been dry for at least six months. Nocturnal enuresis in children is the second most reported pediatric problem after allergic diseases. Many causative factors have been associated with bed-wetting, such as developmental differences, including the development of a child’s urinary sphincters, and diseases like diabetes and urinary tract infections. Having a global incidence of 1.428% among 6-12 years old children, the condition is troublesome for the families of these children, as it can result in considerable emotional distress and psychological consequences. The study revealed that one-third of children in our study sample complained of bed-wetting. Notably, there was significant variability in the estimated prevalence of NE among children in Saudi Arabia, ranging from 12% to 75% according to the study setting and the sampled age groups. The estimated prevalence of nocturnal enuresis in different regions of Iran is reported as 8.25% to 8.8%, compared to other studies conducted in Hong Kong, China, and Thailand. The current study also revealed that nearly three-quarters of the children wet their bed between the age of 5-6 years, as many children have incomplete toilet training by this age and the immature nervous system is unable to fully control the bladder. Regarding the risk factors analyzed among the current study in the children resorting to bed-wetting, child-related stressors were reported in almost half of the sampled children; it included ADHD, which is a major risk factor detected in different studies, dark phobia, stress and anxiety, family troubles and parental separation, exposure to bullying, and physical abuse. We also observed that few children had a positive family history of nocturnal enuresis, one of the main risk factors, besides the water source, which was bottled water in nearly half of the sample.

• #52 Revista de Pediatría de Atención Primaria – Nocturnal enuresis. Epidemiological study in school population

  https://pap.es/article/12209/nocturnal-enuresis-epidemiological-study-in-school-population

  Nocturnal enuresis (NE) is a common childhood health condition. This problem causes personal and social repercussion. The aim of this study is to know the prevalence of NE in children between seven and ten years old of the city of Burgos. The prevalence of NE was 7.3%. NE is more frequent in males and children with familiar precedents of NE, with some type of chronic illness, with associated disorders of the sleep and behavior and with low academic performance. The prevalence of NE in children in Burgos city is lower than in another child groups of similar characteristics. There is a low diagnosis rate of NE in Burgos city. Nocturnal enuresis is a frequent complaint in primary care (PC) paediatric practice, with an estimated prevalence that ranges from 8% to 15%. The trigger or cause of NE remains unknown, and it is generally considered to be multifactorial. We designed an epidemiological study to gain a deeper understanding of the characteristics of the population of children with enuresis in the city of Burgos (Spain), and to identify the main risk factors associated with this condition. The reference population consisted of children aged 7 to 10 years enrolled in public, private, or subsidised private schools in the city of Burgos during the 20132014 academic year. The prevalence we found for the city of Burgos was lower than the prevalence found in populations of similar characteristics. There is an even greater difference in relation to the prevalence found in populations in rural areas or developing countries. This peculiarity highlights the fact that the prevalence of NE depends to a great extent on cultural and social factors. Our study found a high percentage of family history of NE. This is evidence of familial aggregation in NE. Our study also found a higher prevalence of sleep and behavioural disorders in enuretic children. We found this striking. This finding suggests an association between NE and ADHD, consistent with the findings of other studies. The two conditions are probably interrelated, with NE being the cause in some instances and poor school performance in other instances being secondary to a learning disorder or psychomotor delay that is also the cause of NE. The population characteristics and risk factors of patients with NE resemble those found in similar populations. It is important that NE is well understood by health professionals that provide care for children and also by parents and educators.

• #53 Australian community health practitioners’ knowledge and experience with managing urinary incontinence that begins in childhood

  https://www1.racgp.org.au/ajgp/2019/january%E2%80%93february/managing-urinary-incontinence-that-begins-in-child

  Urinary incontinence (enuresis and daytime urinary incontinence) is encountered in approximately 10% of school-aged children. This stigmatising condition can affect self-esteem, health and quality of life, all of which improve with successful treatment. Although there is spontaneous remission in many patients, urinary incontinence in childhood can progress to adulthood with devastating consequences. […] Although it is assumed that children with urinary incontinence would initially present to a general practitioner (GP), it is uncertain how commonly they present. One Australian study from 1996 found that only 34% of families with children who have urinary incontinence seek professional help. Another Australian study from 2018 found that 45% of paediatricians consultations are related to enuresis.

• #54 The Epidemiology And Factors Associated Withnocturnal Enuresis Among School & Preschool Children In Hail City, Saudi Arabia: A Cross-sectional Study.

  https://www.journalijar.com/article/17212/the-epidemiology-and-factors-associated-withnocturnal-enuresis-among-school-&-preschool-children-in-hail-city,-saudi-arabia:-a-cross-sectional-study/

  Background: Enuresis, which is frequently diagnosed amongst school-children, is an important psychosocial problem for both parents and children. […] Objectives: In the present study, we aimed to determine the prevalence and associated factors of enuresis in Saudi children in Hail, and to identify common methods used for its management. […] Results: Of the 700 questionnaires distributed, 652 (93.14%) were completed. The overall prevalence of nocturnal enuresis was 22.7% (n = 148). Female gender, young age, history of enuresis among parents or siblings, deep sleep and history of urinary tract infections and other social and psychological problems were associated factors with enuresis. […] Conclusion: Our results with enuresis prevalence and associated factors were comparable to other epidemiologic studies from various countries. Furthermore, we demonstrated that families in Hail do not pay sufficient attention to enuresis and most of enuretic children do not receive professional treatment.

• #55

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Nocturnal-Enuresis-in-Teens.aspx

  Bedwetting may have an emotional impact on both children and their families. Children may get embarrassed, feel anxious, or develop low self-esteem. This can affect their relationships, quality of life, and schoolwork. […] Yes. However, treatment for bedwetting first depends on if it is caused by something like stress, which would need to be managed first. Overall, children who take an active part in their treatment have a better chance of decreasing or stopping the bedwetting. […] Bedwetting almost always goes away on its own. Most children will grow out of it by the late teenage years or sooner. Secondary enuresis may go away when the cause is found. It is either treated, or it gets better on its own. If bedwetting has not stopped in the late teenage years, your child should be seen by a doctor.

• #56 Bed-wetting – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685

  Several factors have been linked with an increased risk of bed-wetting, including: Stress and anxiety. Stressful events may trigger bed-wetting. Examples include having a new baby in the family, starting a new school or sleeping away from home. […] Although frustrating, bed-wetting without a physical cause does not result in any health risks. But bed-wetting can create some issues for your child, including: Guilt and embarrassment, which can lead to low self-esteem.

• #57 Australian community health practitioners’ knowledge and experience with managing urinary incontinence that begins in childhood

  https://www1.racgp.org.au/ajgp/2019/january%E2%80%93february/managing-urinary-incontinence-that-begins-in-child

  Although almost all practitioners chose a correct first-line management response for childhood urinary incontinence, they were generally less knowledgeable about managing enuresis that has persisted into adulthood. The selection of some incorrect answers about first-line management, particularly for managing childhood daytime urinary incontinence, is concerning: some of the chosen options are potentially harmful, such as the use of desmopressin for treating daytime urinary incontinence, which could cause hyponatraemia and seizures if given during the day without fluid restriction. […] This study highlights the education needs of community health practitioners in regard to the management of urinary incontinence that begins in childhood. If not adequately addressed in childhood, urinary incontinence can progress to adulthood, increasing the risk of depression, low self-esteem and sleep disturbances, and affecting lifestyle choices and quality of life.

• #58 Bed-wetting (nocturnal enuresis) in children

  https://parentingscience.com/bed-wetting/

  Decades of research indicates that nocturnal enuresis has a genetic component. […] It’s possible. In particular, the early use of an approach called “elimination communication” (EC) has been linked with lower rates of bed-wetting. […] As noted above, it’s important to treat any underlying diseases, infections, and sources of stress. But for most kids with primary nocturnal enuresis, these steps aren’t likely to solve the problem. Currently, the therapies with the best evidence in their favor are: bed-wetting alarms, and desmopressin, a synthetic version of the anti-diuretic hormone, vasopressin. […] Bed-wetting alarms use the same technology as diaper alarms. […] A recent, controlled study suggests that this is possible. […] Kids suffering from nocturnal enuresis don’t wet the bed on purpose. It’s unfair to blame or punish them for bed wetting. […] To date, there is little evidence that rewards are effective. […] For more information about nocturnal enuresis, check out the article, Bed-wetting in scientific perspective: Destructive myths and misconceptions.

• #59

  https://journals.lww.com/jfmpc/fulltext/2018/07050/prevalence_of_nocturnal_enuresis_among_children_in.16.aspx

  Nocturnal enuresis (NE) is commonly known as any intermittent incontinence while asleep in a child being at least 5-year old. This study is aimed to estimate the prevalence of NE among children and to identify the characteristics of children who has NE. The prevalence of NE was 18.5% among families with a higher prevalence in boys. Prevalence of NE decreased with increasing age with many children found of having stressful events in their life other than parents divorce. We would like to refer that it is important for families that have children with NE to seek medical consultation immediately, which can lead to behavioral modifications. NE is recognized as a worldwide health disorder in young children. We found the prevalence of NE to be 18.5% among families in Primary Health Care Centers of Family and Community Medicine with a higher prevalence in boys, which is in-line with a previous survey in Saudi Arabia which found that the prevalence of NE were more in boys (16.3%) than in girls (13.8%). Our results showed that all the children with NE were wetting their bed at night time with higher frequencies every week than every night. We would like to refer that it is important for families that have children with NE to seek medical consultation immediately, which can lead to significant improvement of their children.

• #60 Australian community health practitioners’ knowledge and experience with managing urinary incontinence that begins in childhood

  https://www1.racgp.org.au/ajgp/2019/january%E2%80%93february/managing-urinary-incontinence-that-begins-in-child

  Although almost all practitioners chose a correct first-line management response for childhood urinary incontinence, they were generally less knowledgeable about managing enuresis that has persisted into adulthood. The selection of some incorrect answers about first-line management, particularly for managing childhood daytime urinary incontinence, is concerning: some of the chosen options are potentially harmful, such as the use of desmopressin for treating daytime urinary incontinence, which could cause hyponatraemia and seizures if given during the day without fluid restriction. […] This study highlights the education needs of community health practitioners in regard to the management of urinary incontinence that begins in childhood. If not adequately addressed in childhood, urinary incontinence can progress to adulthood, increasing the risk of depression, low self-esteem and sleep disturbances, and affecting lifestyle choices and quality of life.

• #61 Evaluation and management of enuresis in the general paediatric setting | Canadian Paediatric Society

  https://cps.ca/en/documents/position/evaluation-and-management-of-enuresis-in-the-general-paediatric-setting

  Serious medical conditions do not usually present as primary or secondary enuresis. […] Children with monosymptomatic enuresis often have one large void early in the night. […] Enuresis that occurs every night is less likely to resolve spontaneously or respond to treatment than intermittent enuresis. […] In primary monosymptomatic enuresis, the mainstay of management is education and reassurance that no treatment is necessary. […] For children who are bothered by enuresis, and whose self-esteem is affected, and for families who are distressed by their child’s bedwetting, education and reassurance is still the appropriate initial management. […] Many children who find enuresis stressful, unpleasant, and a source of unhappiness respond positively to treatment. […] Importantly, for all children and youth, LUTS and identifiable comorbidities such as constipation need to be addressed before active intervention. […] Alarm studies have demonstrated varying success rates, typically with an initial response of 60% to 80%. […] Evidence is emerging for the benefits of combining treatments for enuresis.

• #62

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Nocturnal-Enuresis-in-Teens.aspx

  Bedwetting may have an emotional impact on both children and their families. Children may get embarrassed, feel anxious, or develop low self-esteem. This can affect their relationships, quality of life, and schoolwork. […] Yes. However, treatment for bedwetting first depends on if it is caused by something like stress, which would need to be managed first. Overall, children who take an active part in their treatment have a better chance of decreasing or stopping the bedwetting. […] Bedwetting almost always goes away on its own. Most children will grow out of it by the late teenage years or sooner. Secondary enuresis may go away when the cause is found. It is either treated, or it gets better on its own. If bedwetting has not stopped in the late teenage years, your child should be seen by a doctor.

• #63 Bedwetting

  https://www.rch.org.au/kidsinfo/fact_sheets/bedwetting/

  Bedwetting is not often a behavioural problem and children rarely do it for attention. It is far more likely that they have little control or awareness when they are having accidents overnight. […] You may wish to see a doctor about your child’s bedwetting if: your child is at least seven years old (treatment for bedwetting is not recommended before this age as treatment is less effective and many children get better on their own), you or your child are troubled or frustrated by the bedwetting, you punish, or are concerned that you might punish, your child for wetting the bed, your child wets or has bowel movements in their pants during the daytime. […] Bedwetting alarms are thought to be the most useful and successful first-step to treat bedwetting. Research has shown these alarms will help 80 per cent of children to become dry, and most children will then stay dry.

• #64 How to Help Older Children Overcome Bedwetting | Children’s Hospital of Philadelphia

  https://www.chop.edu/news/health-tip/how-help-older-children-overcome-bedwetting

  At what age is bedwetting a problem? It’s a common question fielded by pediatricians everywhere. […] Bedwetting among older children is common, but can be uncomfortable and embarrassing for children and frustrating for parents. Because it’s rarely talked about among friends and extended family members, both parents and children can feel like there is something wrong with them when bedwetting continues into the elementary years and beyond. […] Experts estimate that 15 to 20 percent of children between the ages of 5 and 7 wet their beds at least occasionally. The numbers drop steadily as children age, down to about 2 percent at age 16. “About 15 percent of children who wet the bed will become dry every year,” says Kirk. […] In some cases, especially when bedwetting is a new occurrence, it can be a sign of another health problem. If your child is older than 7 and has started to wet the bed after many months of being dry, talk to your pediatrician. Your child’s primary care provider will ask if there have been any stressful events or changes in your child’s life, and can screen for health problems such as diabetes, constipation, sleep apnea or a urinary tract infection.

• #65 How to Help Older Children Overcome Bedwetting | Children’s Hospital of Philadelphia

  https://www.chop.edu/news/health-tip/how-help-older-children-overcome-bedwetting

  At what age is bedwetting a problem? It’s a common question fielded by pediatricians everywhere. […] Bedwetting among older children is common, but can be uncomfortable and embarrassing for children and frustrating for parents. Because it’s rarely talked about among friends and extended family members, both parents and children can feel like there is something wrong with them when bedwetting continues into the elementary years and beyond. […] Experts estimate that 15 to 20 percent of children between the ages of 5 and 7 wet their beds at least occasionally. The numbers drop steadily as children age, down to about 2 percent at age 16. “About 15 percent of children who wet the bed will become dry every year,” says Kirk. […] In some cases, especially when bedwetting is a new occurrence, it can be a sign of another health problem. If your child is older than 7 and has started to wet the bed after many months of being dry, talk to your pediatrician. Your child’s primary care provider will ask if there have been any stressful events or changes in your child’s life, and can screen for health problems such as diabetes, constipation, sleep apnea or a urinary tract infection.

• #66 Nocturnal Enuresis | PPT

  https://www.slideshare.net/slideshow/nocturnal-enuresis-91654488/91654488

  The treatment of monosymptomatic nocturnal enuresis should be marked by a conservative, gentle, and patient approach. Treatment can begin with: parent-child education, charting with rewards for dry nights, voiding before bedtime, night awakening 2-4 hr after bedtime, making sure that parents do not punish the child for enuretic episodes. […] If this approach fails, urine alarm treatment is recommended. Application of an alarm for a period of 8-12 wk can be expected to result in a 75-95% success in the arrest of bedwetting. The underlying conditioning principle likely lies in the alarm’s being an annoying awakening stimulus that causes the child to awaken in time to go to the bathroom and/or retain urine in order to avoid the aversive stimulus. Urine alarm treatment has been shown to be of equal or superior effectiveness when compared to all other forms of treatment.

• #67 Nocturnal Enuresis | PPT

  https://www.slideshare.net/slideshow/nocturnal-enuresis-91654488/91654488

  Pharmacotherapy for nocturnal enuresis is second-line treatment. Desmopressin acetate (DDAVP) is a synthetic analog of the antidiuretic hormone (ADH) vasopressin, which decreases nighttime urine production. The fast action of DDAVP suggests a role for special occasions (e.g., sleepovers), when rapid control of bedwetting is desired. Unfortunately, the relapse rate is high when DDAVP is discontinued. DDAVP is also associated with rare side effects of hyponatremia and water intoxication, with resulting seizures. […] Although imipramine has some usefulness, less than 50% of children respond, and most relapse when the medication is discontinued. Bothersome side effects and potential lethality in overdose also limit this medication’s usefulness. Much less commonly used, oxybutynin and tolterodine are antimuscarinic drugs, which may be effective by reducing bladder spasm and increasing bladder capacity.

• #68 Evaluation and management of enuresis in the general paediatric setting | Canadian Paediatric Society

  https://cps.ca/en/documents/position/evaluation-and-management-of-enuresis-in-the-general-paediatric-setting

  Serious medical conditions do not usually present as primary or secondary enuresis. […] Children with monosymptomatic enuresis often have one large void early in the night. […] Enuresis that occurs every night is less likely to resolve spontaneously or respond to treatment than intermittent enuresis. […] In primary monosymptomatic enuresis, the mainstay of management is education and reassurance that no treatment is necessary. […] For children who are bothered by enuresis, and whose self-esteem is affected, and for families who are distressed by their child’s bedwetting, education and reassurance is still the appropriate initial management. […] Many children who find enuresis stressful, unpleasant, and a source of unhappiness respond positively to treatment. […] Importantly, for all children and youth, LUTS and identifiable comorbidities such as constipation need to be addressed before active intervention. […] Alarm studies have demonstrated varying success rates, typically with an initial response of 60% to 80%. […] Evidence is emerging for the benefits of combining treatments for enuresis.

• #69 Evaluation and management of enuresis in the general paediatric setting | Canadian Paediatric Society

  https://cps.ca/en/documents/position/evaluation-and-management-of-enuresis-in-the-general-paediatric-setting

  Serious medical conditions do not usually present as primary or secondary enuresis. […] Children with monosymptomatic enuresis often have one large void early in the night. […] Enuresis that occurs every night is less likely to resolve spontaneously or respond to treatment than intermittent enuresis. […] In primary monosymptomatic enuresis, the mainstay of management is education and reassurance that no treatment is necessary. […] For children who are bothered by enuresis, and whose self-esteem is affected, and for families who are distressed by their child’s bedwetting, education and reassurance is still the appropriate initial management. […] Many children who find enuresis stressful, unpleasant, and a source of unhappiness respond positively to treatment. […] Importantly, for all children and youth, LUTS and identifiable comorbidities such as constipation need to be addressed before active intervention. […] Alarm studies have demonstrated varying success rates, typically with an initial response of 60% to 80%. […] Evidence is emerging for the benefits of combining treatments for enuresis.

• #70 Urine metabolic phenotyping in children with nocturnal enuresis and comorbid neurobehavioral disorders | Scientific Reports

  https://www.nature.com/articles/s41598-021-96104-1

  Nocturnal enuresis (NE) is a common problem among 10% school-aged children. […] The literatures reported the prevalence of childhood NE is highly variable among different countries, ranging from 2.3 to 25%. […] In Taiwan, there was 6.8% of elementary-school children reported to have the bedwetting problem. […] Overall, the global prevalence of NE is around 10% among school-aged children, particularly predominance in boys. […] Notably, if bedwetting children and adolescents are not treated properly or ignored without treatment, there is 2% of the population persistent into adulthood. […] However, 40% of bedwetting children and adolescents still have insufficient responses to the standard treatment or experience a relapse after stopping treatment, particularly for those with NMNE. […] The prevalence estimates of enuresis in children with ADHD have been reported in 22-32%.

• #71 Epidemiology of enuresis: a large number of children at risk of low regard | Italian Journal of Pediatrics | Full Text

  https://ijponline.biomedcentral.com/articles/10.1186/s13052-020-00896-3

  To describe the epidemiological aspects of nocturnal enuresis (NE). In this study we identify the prevalence and the familial conditions in a large, representative sample of children with monosymptomatic NE (MNE) and nonmonosyptomatic NE (NMNE). […] The prevalence of NE is variable. It is above 10% among 6year-old, around 5% among 10year-old, and 0.51% among teenagers and young adults. […] Despite the high prevalence of NE, doctors in a primary care setting may have difficulty in the evaluation and management of this condition. […] In this study we aimed to describe the different epidemiological aspects of NE in children from Italy analysing prevalence and type of NE, comorbidity, therapeutic choices, pharmacological and psychological/behavioural interventions, dietary associated factors in samples collected from Italian Pediatricians.

• #72 Acta Scientific | International Open Library | Open Access Journals Publishing Group

  https://actascientific.com/ASMS/ASMS-05-0939.php

  Enuresia remains unknown in the Democratic Republic of Congo. The objective was to assess the epidemiology and social impact of bedwetting in order to promote the overall management of enuretic children in Mbujimayi. […] Bedwetting is a common disorder in households, with a significant social impact. Raising awareness among enuretic children about the need to consult a doctor for care would be an asset in mitigating the consequences of this disorder.

• #73 Acta Scientific | International Open Library | Open Access Journals Publishing Group

  https://actascientific.com/ASMS/ASMS-05-0939.php

  Enuresia remains unknown in the Democratic Republic of Congo. The objective was to assess the epidemiology and social impact of bedwetting in order to promote the overall management of enuretic children in Mbujimayi. […] Bedwetting is a common disorder in households, with a significant social impact. Raising awareness among enuretic children about the need to consult a doctor for care would be an asset in mitigating the consequences of this disorder.

• #74 Enuresis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK545181/

  Enuresis, commonly known as bedwetting, is a prevalent pediatric condition affecting approximately 15% of 5-year-old children. […] The prevalence of enuresis is similar across cultures and varies with age, with males affected twice as often as females. By age 4, nearly 25% of children experience frequent bedwetting; by 5, the condition affects approximately 15% of children. Once children reach 8, the incidence is 4%. However, due to the stigma associated with enuresis, many cases go unreported, making the true prevalence challenging to ascertain. […] The International Children’s Continence Society reports that 20% to 30% of children with enuresis have at least 1 mental health condition, approximately twice the rate of non-wetting children. The most frequently cited disorder accompanying enuresis is attention deficit hyperactivity disorder, but others include autism spectrum disorder, oppositional defiant disorder, and mood disorders. This link is an association, not proof of causation since enuresis can result in feelings of shame, embarrassment, and frustration, which then lead to anxiety and depression.

Zobacz więcej