Psychological changes have been associated with symptoms of urgency and urinary incontinence. Thus 89 orphans were compared with 143 schoolchildren not in institutions. A questionnaire was devised and completed by the care-taking staff in the orphanage, while for the schoolchildren the parents completed the questionnaire. The mean age in the institutionalised children was 7.9 years and that of the control group 7.8 years ( P = 0.32). Thirty-nine (44%) of the orphans were boys, vs 74 (54%) of the control group ( P = 0.17).
RESULTSThe incidence of urgency, diurnal urinary incontinence, nocturnal enuresis and constipation in the orphans and in the control group were: 45 (51%) and 57 (40) ( P = 0.17), 36 (40%) and 19 (13%) ( P < 0.001), 39 (47%) and 38 (27%) ( P = 0.002), and 27 (30%) and 43 (30%) ( P = 0.76), respectively.
CONCLUSIONChildren living in orphanages have a significantly higher level of diurnal urinary incontinence and nocturnal enuresis than those not in an institution.
Most children with LUTD presented a previous UTI, and daily incontinence was verified in around 75% of the patients. Complaints of polaciuria or infrequent micturition are not noted completely in the micturition diaries and there is no parameter in the clinical history that offers good sensitivity or specificity for the diagnosis of lack of perineal coordination.
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