Shah Sameena, Jafri Rabab Zehra, Mobin Khalil, Mirza Rabeea, Nanji Kashmira, Jahangir Fatima, Patel Sufian Jawed, Ejaz Muzamil Shabana, Qaiser Iman, Iftikhar Hira, Aziz Komal, Khan Wajiha, Maqbool Humza S, Ahmed Hassaan
Department of Family Medicine, Aga Khan University, Stadium Road, Karachi, Pakistan.
Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA, USA.
BMC Fam Pract. 2018 Dec 14;19(1):198. doi: 10.1186/s12875-018-0876-5.
Nocturnal enuresis (NE) is a common symptom in children worldwide. International Children's Continence Society (ICCS) defines enuresis as either mono-symptomatic, NE with lower urinary tract symptoms and NE with co-morbid conditions. The objectives of this study were to determine the frequencies and types of NE and associated symptoms and conditions in children aged 5 to 16 years based on ICCS criteria.
A multi-center cross sectional study was conducted between November 2012 and December 2013 in the primary care clinics of four hospitals in Karachi. Children aged five to fifteen years were included through consecutive sampling. Informed consent was obtained from the parents and a pre-coded semi-structured questionnaire was used to obtain the information. Data was entered on SPSS version 20.0 and multivariable logistic regression analysis was used for data analysis.
Out of 429 children aged between five and sixteen years, 243(56.9%) were boys and the remaining 186(43.1%) were girls. One hundred and eighty three children (43%) had nocturnal enuresis (NE). Forty four (10.3%), had mono-symptomatic NE, 57(31.1%) had associated lower urinary tract symptoms (NE-LUTS), whereas 30 (16.3%) had NE with a co-morbid condition. Fifty two (28.4%) NE's had at least one of both LUTS and a co-morbid condition. Out of the 246(57%) non-enuretic's, 31(12.6%) had a LUTS, 95(38.6%) had a co-morbid condition and 57(23.2%) had at least one of both LUTS and a co-morbid condition. The remaining 63 (25.6%) were symptom free. Increased voiding frequency, urgency, dysuria, suprapubic pain and daytime incontinence were the LUTS significantly associated with NE. Co-morbid conditions significantly associated with NE included constipation, congenital defects, developmental delay, and learning and sleep problems.
Although NE can be an only symptom, it is often associated with lower urinary tract symptoms like dysuria, urgency, suprapubic pain, and daytime incontinence. Children presenting with NE often have co-morbid conditions like constipation, urinary tract infection, sleep disorders, and developmental delay. Many children presenting with these conditions as the primary complaint may also have NE. It should be addressed as unrecognized and untreated NE can cause additional morbidity and distress.
夜间遗尿（NE）是全球儿童的常见症状。国际儿童尿控协会（ICCS）将遗尿定义为单纯症状性、伴有下尿路症状的NE以及伴有共病的NE。本研究的目的是根据ICCS标准确定5至16岁儿童中NE的频率、类型以及相关症状和疾病。
2012年11月至2013年12月在卡拉奇四家医院的初级保健诊所进行了一项多中心横断面研究。通过连续抽样纳入5至15岁的儿童。获得了家长的知情同意，并使用预先编码的半结构化问卷获取信息。数据录入SPSS 20.0版本，采用多变量逻辑回归分析进行数据分析。
在429名5至16岁的儿童中，243名（56.9%）为男孩，其余186名（43.1%）为女孩。183名儿童（43%）有夜间遗尿（NE）。44名（10.3%）为单纯症状性NE，57名（31.1%）伴有下尿路症状（NE-LUTS），而30名（16.3%）伴有共病。52名（28.4%）NE患者至少有LUTS和共病中的一种。在246名（57%）无遗尿的儿童中，31名（12.6%）有LUTS，95名（38.6%）有共病，57名（23.2%）至少有LUTS和共病中的一种。其余63名（25.6%）无症状。排尿频率增加、尿急、尿痛、耻骨上疼痛和日间尿失禁是与NE显著相关的LUTS。与NE显著相关的共病包括便秘、先天性缺陷、发育迟缓以及学习和睡眠问题。
虽然NE可能只是一种症状，但它通常与尿痛、尿急、耻骨上疼痛和日间尿失禁等下尿路症状相关。出现NE的儿童通常有便秘、尿路感染、睡眠障碍和发育迟缓等共病。许多以这些疾病为主诉就诊的儿童也可能有NE。应予以关注，因为未被识别和未治疗的NE可能导致额外的发病率和痛苦。
