Childhood nocturnal enuresis-a marker for pelvic floor disorders and urinary tract symptoms in women?

INTRODUCTION AND HYPOTHESIS

A systematic survey on the association between childhood nocturnal enuresis (CNE) and adult pelvic floor disorders (PFDs) has not been presented previously. The aim was to describe the prevalence of PFDs and lower urinary tract symptoms in nulliparous women, with or without a history of CNE, at the age of ≥ 5 years.

METHODS

This national survey of urinary (UI) and fecal incontinence (FI) and symptoms of pelvic organ prolapse (sPOP) was a random sample of 20,000 nulliparous women aged 25-64 years conducted in 2014. Women ≥ 5 years of age having CNE were compared with those without the condition. Fisher's exact test and logistic regression adjusted for BMI and age were used to analyze differences between groups.

RESULTS

The response rate was 52% and 10.2% of adult women reporting CNE. One or more PFDs occurred in 38.3% of women with CNE compared to 23.8% in those without CNE (p < 0.0001). Mixed UI had the strongest association with CNE, odds ratio (OR) 2.63 (95% CI 2.03-3.40). The rate of FI was 11.2% in the non-CNE group and 16.8% in those with CNE (p < 0.0001) and sPOP 2.6% in the non-CNE and 4.8% in the CNE group (p = 0.0004), respectively. The prevalence of lower urinary tract symptoms was consistently higher in women with a history of CNE: overactive bladder 32.6% versus 18.4% (OR 2.34 95% CI 2.03-3.40), daytime micturition ≥ 8/day 29.6% versus 24.0% (p < 0.0001), and nocturia ≥ 2/night 12.4% versus 7.8% (p < 0.0001) in the CNE group.

CONCLUSION

PFDs and lower urinary tract symptoms in nulliparous women were approximately doubled in women with a history of CNE and could therefore act as a strong confounding factor.