Epidemiological Investigation On Nocturnal Enuresis And Its Related Factor In School Children In Chengdu

Objective:To study epidemiological characteristics and the related factors of nocturnal enuresis in school children in Chengdu,to provide the reference for the prevention and treatment of the disease.Methods:We send a questionnaire randomly to parents of12000 school children,aged 5-18 years.The questionnaire included demographic characteristics of the child and family,cross-sectional questions about nocturnal enuresis and the age of stopping bedwetting.Results:12000 questionnaires were actually sent,and 11348 was in response.Of which,10466 questionnaires were finally used for statistic analysis.1.In cross-sectional study of 10466 children,5154 were boys(49.2%)and 5312 were girls(50.8%).The overall prevalence of NE was 3.9%,prevalence was 9.4% in 5-years group,decline with age,and stablized at around 2.0% after 12 years old.There were 326 cases nocturia children in 5 to 11 years old,and 77 cases in 12 to 18 years old,the former was significantly greater than the latter.The prevalence of NE among boys and girls was 5.9%and 2.6%,the difference was statistically significant.(P<0.05).2.Retrospective study the prevance of NE in 5-year group was9.0%,1.33% in 8-year group,and was under 1.0% after 9 years old.Retrospective study of Prevancre in both boys and girls of NE were lower than the cross-sectional study.3.Factors associated with NE include age,male gender,introversion,hyperactivity,inattention,physical condition of mother in pregnant,family history of enuresis.The Logistic regression showed that age,gender,introversion,hyperactivity,positive family history of enuresis was the risk factors of children in nocturnal enuresis(age:OR=1.029,95%CI1.015~1.044,P<0.05;gender:OR=1.538,95%CI1.393~1.698,P<0.05;introversion:OR=1.321,95%CI1.126~1.55,P<0.05;hyperacti vity: OR=1.285,95%CI1.151~1.436,P<0.05;positive family history of enuresis:OR=3.691,95%CI2.937 ~4.639,P<0.05).4.194 cases(50.5%)began to wet the bed from the age of 1 year,and the most favorable season for the bedwetting was winter(47.9%).About 70% of children used to eat sweets and drink water before going to bed.There were 225 children with PNE(64.8%)and 122 children with SNE(35.2%).54 patients(15%)were with symptoms of daytime urinary tract symptoms(urinary frequency,urgency,wetting bed during nap),which was significantly lower than the number of MNE(85%).Although 275 cases(70.7%)slept over 9hours per night,223 cases(57.9%)woke up after bedwetting,208 cases(53.8%)of bedwetting occurred 5 hours after sleep,and 175 cases(48.3%)slept too deep to wake up.There were 278 patient(73.1%)who wetted bed≤ 3 times per week,58 cases(15.2%)in 4~6 times per week,and 43 cases(11.7%)more than 7 times per week.The number of children with frequent bed-wetting was different between 5~11 years old and 12~18 years old.12 to 18 years old group(30/74,40.5%)was more than 5~11 years old group(71/305,23.3%),the difference was statistically significant(P<0.05).241 cases(66.8%)of parents thought that the bed-wetting should disappear without medical treatment.190 cases(52.6%)had urination training,of which 42 cases(22.1%)were violent.175 cases(47.9%)used diapers.145 cases(39.9%)went to a doctor for bedwetting treatment,94 cases(64.8%)treated with behavioral therapy,49 cases(33.8%)with oral desmopressin,2 cases(1.4%)with behavioral therapy and drug treatment,97 cases(66.9%)symptoms improved significantly or disappeared after treatment,there was no statistically significant difference effect of drug therapy and behavior therapy.There were 60 cases(60/95,63.2%)of the children with frequent bed-wetting who saw a doctor,which was significantly higher than the children with infrequent bed-wetting(89/260,34.2%),and the difference was statistically significant(P<0.05).Conclusion:1.The overall prevalence of NE is 3.9% in Chengdu area,the prevalence of children aged 5 to 11 is 3.6% to 9.4%,and around 2.0%after 12 years old,the overall morbidity of enuresis decreases with age.2.In this group,children with frequent bed-wetting were more likely to develop the symptoms of bed-wetting into adulthood.3.Male,introversion,hyperactivity and family history of the family may be the risk factors for children’s enuresis in the region.The incidence of NE in this area is slightly older,and the incidence of SNE is relatively high.4.The data showed that parents’ awareness of the disease and the compliance of disease treatment were insufficient.The prevention and treatment of the disease should be strengthened and further standardized treatment and management.