Summary
Introduction
The International Children's Continence Society (ICCS) defines urinary incontinence
(UI) as ‘involuntary leakage of urine’ [
[1]
], a condition that can have a negative impact on a child's life. Although UI is common
among children, the reported prevalences worldwide vary. Regarding children in the
Netherlands, only a few studies report on the prevalence of UI and other lower urinary
tract symptoms (LUTSs).Objective
The aim was to investigate the prevalence of episodes of UI and other LUTSs along
with associated ‘risk factors’ in children in the Netherlands.
Study design
In a cross-sectional study, 240 children (8- to 17-year-olds) were included, who completed
the Groningen Pediatric Defecation and Fecal Continence Questionnaire. UI was defined
in accordance with the ICCS's definition of involuntary leakage of urine. To define
a timeframe of episodes of UI, the situation during the past 6 months was specifically
asked. The other LUTSs included were intermittency, straining, urinary tract infections,
nocturia, and frequency.
Results
The prevalence of episodes of UI in the total group was 21.7%. Girls experienced UI
significantly more often than boys (30.1% versus 14.2%, P = 0.003). Prevalence did not differ between the 8- to 12-year-olds and the 13- to
17-year-olds. The most prevalent form of UI was stress UI (8.8%). After excluding
six children with a medical history that could influence bladder function, UI in 20.9%
of the remaining ‘healthy’ children was found. Intermittency was experienced by 18.3%
of the children, and 15% strained during micturition. Univariate analysis showed that
the presence of straining, intermittency, nocturia, or fecal incontinence was significantly
associated with UI.
Discussion
Of the children studied, episodes of UI occurred in 21.7%, and the condition did not
decrease with age. It was found that UI is not limited to ‘sick’ children because
it occurred in 20.9% of the ‘healthy’ subgroup. Although children with urge UI in
daily practice were mainly seen, in this study, it was found that on average, stress
UI was the most common form of UI among Dutch children. The prevalence of other LUTSs
was also high, with intermittency and straining as the most frequent symptoms (18.3%
and 15.0%, respectively). Intermittency and straining are significantly associated
with UI, as are nightly nocturia and fecal incontinence.
Conclusion
Graphical Abstract
Keywords
Abbreviations:
CI (confidence interval), DeFeC (Groningen Pediatric Defecation and Fecal Continence Questionnaire), ICCS (International Children's Continence Society), LUTSs (lower urinary tract symptoms), UI (urinary incontinence)To read this article in full you will need to make a payment
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References
- The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization committee of the international Children's Continence Society.Neurourol Urodyn. 2015; : 3-14
- Absenteeism, educational plans, and anxiety among children with incontinence and their parents.J Sch Health. 2015 Apr; 85: 241-250
- The natural history of urinary symptoms during adolescence.Br J Urol. 1998 May; 81: 90-93
- An epidemiological study of enuresis in Korean children.BJU Int. 2000 May; 85: 869-873
- Epidemiology of enuresis and urinary incontinence in Children.in: Incontinence : 6th international consultation on incontinence, Tokyo, September 2016. 6th ed. England International Continence Society, Bristol2017: 6-16
- Prevalence of urinary incontinence and lower urinary tract symptoms in school-age children.Urol J. 2014 Jul 8; 11: 1602-1608
- Prevalence of lower urinary tract symptoms in school-age children.Pediatr Nephrol. 2012 Apr; 27: 597-603
- Evaluation of lower urinary tract dysfunction in Turkish primary schoolchildren: an epidemiological study.J Pediatr Urol. 2014 Dec; 10: 1181-1186
- Childhood nocturnal enuresis in The Netherlands.Urology. 1998 Jun; 51: 1022-1026
- Reproducibility, feasibility and validity of the groningen defecation and fecal continence questionnaires.Scand J Gastroenterol. 2018 Apr 27; : 1-7
- On the prevalence of constipation and fecal incontinence, and their co-occurrence, in The Netherlands.Int J Colorectal Dis. 2017 Apr; 32: 475-483
- Urinary incontinence in The Netherlands: prevalence and associated risk factors in adults.Neurourol Urodyn. 2017 Aug; 36: 1519-1528
- Functional anorectal disorders.Gastroenterology. 2016 May; 150 (1430.e4–1442.e4)
- Functional disorders: children and adolescents.Gastroenterology. 2016 May; 150 (1456.e2–1468.e2)
- Richtlijn Diagnostiek en behandeling van obesitas bij volwassenen en kinderen.Kwaliteitsintituut voor de Gezondheidszorg, 2008
- Differences in characteristics of nocturnal enuresis between children and adolescents: a critical appraisal from a large epidemiological study.BJU Int. 2006 May; 97: 1069-1073
- A population based study of 2,856 school-age children with urinary incontinence.J Urol. 2009 Feb; 181 (discussion 815-6): 808-815
- Aetiological and precipitating factors for childhood enuresis.Acta Paediatr Scand. 1991 Mar; 80: 361-369
- Urinary and faecal incontinence: a population-based study.Acta Paediatr. 2004 Mar; 93: 386-389
- Prospective evaluation of the long-term effects of clinical voiding reeducation or voiding school for lower urinary tract conditions in children.J Pediatr Urol. 2016 Feb; 12: 37.e1-37.e6
Article info
Publication history
Published online: November 08, 2018
Accepted:
October 31,
2018
Received:
April 12,
2018
Identification
Copyright
© 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
