New definitions and a standardized terminology are provided, taking into account changes in the adult sphere and new research results.

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The prevalence of incontinence in children has been extensively studied, but knowledge of other bladder symptoms is lacking in a healthy child population. The micturition habits of 3556 7-year-old school entrants were surveyed by a questionnaire supplemented by telephone interviews. One or more symptoms of a disturbed bladder function was reported in 26%, but most of these had moderate urgency as a sign of incomplete voluntary bladder control. Isolated bedwetting occurred in 2.8% of the girls and 7.0% of the boys, whereas nocturnal incontinence combined with daytime wetting was equally common in both sexes, 2.3% and 2.0% respectively. Diurnal incontinence was reported in 6.0% of the girls and 3.8% of the boys and was usually combined with other symptoms. The frequency of micturition in children without symptoms of bladder disturbance and with no previous urinary tract infection was 3-7 times per day.

The association between current micturition habits and previous urinary tract infection was analysed among 3553 school entrants aged 7 years by means of a questionnaire. A high incidence of urinary infection, confirmed by urine culture, was found (145 (8-4%) in the 1719 girls and 32 (1-7%) in the 1834 boys). There was a significant association between current symptoms that were suggestive of disturbed bladder function and previous urinary tract infection, but only among girls who were over 3 years of age at the time the first episode was diagnosed. Another important abnormality in children with recurrent urinary infections is poor coordination between the detrusor and the sphincter.4 Before the amount of residual urine is measured or urodynamic investigations are started, however, the symptoms of the child should be analysed. The most obvious symptom of bladder dysfunction is incontinence, which is associated with urinary infection.5 6 The incidence of other symptoms suggestive of bladder dysfunction is, however, not known. We therefore studied the association between current symptoms suggestive of bladder dysfunction and a history of previous urinary infections in an unselected group of 7 year old school entrants.Subjects and methods All Swedish children attend a health examination together with a parent and the teacher on entering school at the age of 7. Different problems are discussed with the school physician and the school nurse. Before this examination a health questionnaire is given to the families, to use as a basis for discussion. In 1982 an additional questionnaire about current micturition habits and urinary incontinence was given to all Swedish speaking school entrants in Goteborg by the school nurses.7 Previous urinary infections and other diseases of the urinary tract were also investigated. If there was anything abnormal or unanswered in the questionnaire the family was contacted by telephone for more details by one of the investigators. Children with problems were offered further examination at the children's hospital.Nocturnal as well as diurnal incontinence was defined as wetting at least once during a three month period. Urgency was defined as a short latent period between the first sensation and the need to void that occurred daily. Children who were able to postpone micturition voluntarily while they were occupied were not considered to have urgency. A specific question was asked about the use of a squatting position to prevent incontinence (the 'curtsy' sign8) and whether this was used at least once a week. A child was considered to have emptying difficulties when symptoms such as starting difficulties, poor or interrupted stream, straining or manual compression of the bladder, or prolonged micturition occurred more than twice a week.The original records from hospitals and outpatient clinics of children who gave a history of urinary infections or other diseases of the urinary tract were studied, and the diagnosis of urinary tract infection re-evaluated. The growth of at least 105 ...

PurposeWe updated the terminology in the field of pediatric lower urinary tract function.Materials and MethodsDiscussions were held in the board of the International Children's Continence Society and an extensive reviewing process was done involving all members of the International Children's Continence Society, the urology section of the American Academy of Pediatrics, the European Society of Pediatric Urology, as well as other experts in the field.Results and ConclusionsNew definitions and a standardized terminology are provided, taking into account changes in the adult sphere and new research results. Neurourol. Urodynam. 26:90–102, 2007. © 2006 Wiley‐Liss, Inc.

Although familial PNE probably arises from polygenic inheritance, analysis of a large number of families may enable the identification of major susceptibility loci. Recently, linkage analysis with polymorphic markers identified a locus predisposing to PNE, assigned ENUR1, in a proportion of Danish families.'4The gene resides in a 4 cM interval flanked by markers D13S263 and D13S291 on chromosome 13q.In a clinical and genetic study we examined two aspects of PNE. First, we investigated the genetic predisposition to PNE in 392 cases by recording family history of enuresis. Second, we performed linkage analysis in 16 families segregating for dominant PNE. Materials and methods PATIENTSIn a continuing Swedish multicentre study," 392 children (291 boys and 101 girls) older than 6 years were identified. All showed a severe form of PNE including .10 wet nights out of 28 and absence of a dry period >3 months. Concomitant neurological or urological dysfunction associated with PNE was excluded. Evaluation of each patient included physical examination and urine analysis.A detailed family history was recorded in each case in order to determine the presence of familial PNE as defined by any close relative with PNE beyond the age of 6 years. The parents of affected probands underwent a structured interview with specific questions regarding the onset, frequency, and cessation of bedwetting. Direct contact was made with the relatives when the information from the parents indicated a positive family history for PNE. The diagnosis among second and third degree relatives was ascertained, or excluded, with the same criteria as for the proband. Fam-ily members under the age of 7 years were not included.