Othman Jwan Al-Mukhtar, Åkervall Sigvard, Molin Mattias, Gyhagen Maria
Gothenburg Continence Research Centre, Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, 416 85, Göteborg, Sweden.
Int Urogynecol J. 2021 Feb;32(2):359-365. doi: 10.1007/s00192-020-04345-x. Epub 2020 May 30.
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.
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.
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.
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.
此前尚未有关于儿童夜间遗尿症（CNE）与成人盆底功能障碍（PFDs）之间关联的系统性调查。本研究旨在描述≥5岁未生育女性中PFDs及下尿路症状的患病率，这些女性有无CNE病史。
本次关于尿失禁（UI）、粪失禁（FI）及盆腔器官脱垂症状（sPOP）的全国性调查，是于2014年对20000名年龄在25 - 64岁的未生育女性进行的随机抽样。将年龄≥5岁有CNE病史的女性与无此病史的女性进行比较。采用Fisher精确检验以及对体重指数（BMI）和年龄进行校正的逻辑回归分析两组之间的差异。
应答率为52%，10.2%的成年女性报告有CNE病史。有CNE病史的女性中38.3%出现一种或多种PFDs，无CNE病史的女性中这一比例为23.8%（p < 0.0001）。混合性尿失禁与CNE的关联最强，比值比（OR）为2.63（95%可信区间[CI] 2.03 - 3.40）。非CNE组粪失禁发生率为11.2%，CNE组为16.8%（p < 0.0001），非CNE组盆腔器官脱垂症状发生率为2.6%，CNE组为4.8%（p = 0.0004）。有CNE病史女性下尿路症状的患病率始终较高：膀胱过度活动症为32.6% 对比18.4%（OR 2.34，95% CI 2.03 - 3.40），日间排尿≥8次/天为29.6%对比24.0%（p < 0.0001），夜尿≥2次/夜为12.4%对比7.8%（p < 0.0001）。
有CNE病史的未生育女性中PFDs及下尿路症状的发生率约为无此病史女性的两倍，因此可能是一个重要的混杂因素。
