Association between enuresis and obesity in children with primary monosymptomatic nocturnal enuresis

Abstract

Objective The purpose of this study was to determine whether the presence of obesity was related with symptoms of nocturnal enuresis (NE) and the efficacy of behavioral intervention in the treatment of NE.Materials and Method The patients diagnosed with primary monosymptomatic nocturnal enuresis (PMNE) were studied retrospectively. NE severity was classified as mild, moderate, and severe according to the frequency of enuresis. The children were divided into three groups, namely normal weight (5th-84th percentile), overweight (85th-94th percentile), and obesity (≥95th percentile), according to their Body Mass Index (BMI) percentage. The relationship between obesity level and enuresis severity was analyzed. After three months of behavioral therapy, the efficacy of treatment among normal, overweight, and obese groups were evaluated. Moreover, the predictive risk factors for treatment failure were investigated.Results The rates of severe enuresis in patients with normal weight, overweight, and obesity were 63.9%, 77.5%, and 78.6%, respectively. Obese children depicted higher odds of having severe enuresis compared with normal-weight children (OR: 1.571; 95% confidence interval [CI]: 1.196-2.065; P=0.001). The odds of presenting with severe enuresis were 1.99 times higher in children who are obese or overweight compared to children with normal weight (OR: 1.994; 95% CI: 1.349-2.946; P=0.001). The complete response of the normal group was higher than those of the overweight and obese groups (26.8% vs. 14.0%, P=0.010; 26.8% vs. 0.0%, P=0.000). Overweight children showed higher complete response than obese ones (14.0% vs. 0.0%, P=0.009). Logistic regression analysis revealed that obesity level and enuresis frequency were significantly related to the treatment failure of behavioral intervention.Conclusions Obesity is associated with severe enuresis and low efficacy of behavioral therapy in children with nocturnal enuresis.

Behavioral comorbidity, overweight, and obesity in children with incontinence: An analysis of 1638 cases

“…Also, the response rate to behavioral interventions (not to specific incontinence treatments like alarm or desmopressin) were lower if children were overweight or obese. 16 Similarly, Guven et al 20 reported lower response rates for dysfunctional voiding and for NE in these risk groups (including alarm and desmopressin).…”

“…Some studies rely on the definition of the World Health Organisation (WHO) by calculating BMI-z-scores. 13,14 Others define overweight by the 85th and obesity by the 95th BMI-percentile, 15,16 as well as by the 90th and 97th percentile, respectively. 12,17 In a large Chinese nation-wide, population-based study, obese children had a higher risk for NE (OR = 1.42).…”

Association between Attention Deficit Hyperactivity Disorder and lower urinary tract symptoms in children and adolescents in a community setting

“…ADHD and LUTS are not only common disorders in childhood, but also has a high co-existence and interaction with each other (15)(16)(17)(18). The prevalence of ADHD in children and adolescents with LUTS is around 42.3% (19).…”

Prevalence and Determinants of Bad Sleep Perception among Italian Children and Adolescents

“…These modifications are often associated with sleep disruptions. Indeed, numerous surveys report, in young populations, a high prevalence of sleep problems, such as night awakenings [ 5 , 6 ], nightmares [ 7 ], nocturnal enuresis [ 8 , 9 ], sleep onset delay [ 10 , 11 ], and sleep restriction [ 12 ]. Also, the consequences of poor sleep quality on school performance in children and adolescents have been widely explored (see [ 13 ] for a meta-analytic review).…”