Childhood nocturnal enuresis—a marker for pelvic floor disorders and urinary tract symptoms in women?

Abstract

Introduction and hypothesis A systematic survey on the association between childhood nocturnal enuresis (CNE) and adult pelvic floor disorders (PFDs) has not been presented previously. The aim was to describe the prevalence of PFDs and lower urinary tract symptoms in nulliparous women, with or without a history of CNE, at the age of ≥ 5 years. Methods This national survey of urinary (UI) and fecal incontinence (FI) and symptoms of pelvic organ prolapse (sPOP) was a random sample of 20,000 nulliparous women aged 25–64 years conducted in 2014. Women ≥ 5 years of age having CNE were compared with those without the condition. Fisher’s exact test and logistic regression adjusted for BMI and age were used to analyze differences between groups. Results The response rate was 52% and 10.2% of adult women reporting CNE. One or more PFDs occurred in 38.3% of women with CNE compared to 23.8% in those without CNE ( p < 0.0001). Mixed UI had the strongest association with CNE, odds ratio (OR) 2.63 (95% CI 2.03–3.40). The rate of FI was 11.2% in the non-CNE group and 16.8% in those with CNE ( p < 0.0001) and sPOP 2.6% in the non-CNE and 4.8% in the CNE group ( p = 0.0004), respectively. The prevalence of lower urinary tract symptoms was consistently higher in women with a history of CNE: overactive bladder 32.6% versus 18.4% (OR 2.34 95% CI 2.03–3.40), daytime micturition ≥ 8/day 29.6% versus 24.0% ( p < 0.0001), and nocturia ≥ 2/night 12.4% versus 7.8% ( p < 0.0001) in the CNE group. Conclusion PFDs and lower urinary tract symptoms in nulliparous women were approximately doubled in women with a history of CNE and could therefore act as a strong confounding factor. Electronic supplementary material The online version of this article (10.1007/s00192-020-04345-x) contains supplementary material, which is available to authorized users.

Potential associations of adult nocturia. Results from a national prevalence study

“…The authors concluded that childhood symptoms as nocturia and nocturnal enuresis were strongly associated with symptoms in middle‐aged and older women. An internet‐based questionnaire survey conducted by Othman et al 35 described the prevalence of nocturia ≥2 was higher in women with a history of childhood enuresis. However, this study was based only on the female population.…”

Transition from Childhood Nocturnal Enuresis to Adult Nocturia: A Systematic Review and Meta-Analysis

“…Most ORs of the individual studies ranged between 1.00 and 2.00. 23 , 25 , 27–29 Specifically, studies 1, 5, 6, and 7 showed statistically significant associations between the two conditions (OR: 2.38, CI: 1.94–2.94; OR: 1.39, CI: 1.20–1.57; OR: 1.91, CI: 1.53–2.38; OR: 3.75, CI: 2.55–5.52; respectively). 22 , 25 , 26 , 28 Overall, the pooled random effects model also showed a significant association between NE and nocturia (OR: 1.75, CI: 1.11–2.40).…”

“… 23 , 25 , 27–29 Specifically, studies 1, 5, 6, and 7 showed statistically significant associations between the two conditions (OR: 2.38, CI: 1.94–2.94; OR: 1.39, CI: 1.20–1.57; OR: 1.91, CI: 1.53–2.38; OR: 3.75, CI: 2.55–5.52; respectively). 22 , 25 , 26 , 28 Overall, the pooled random effects model also showed a significant association between NE and nocturia (OR: 1.75, CI: 1.11–2.40). A pooled random effects model was used in order to take into account both within- and between-study variability when calculating pooled OR estimates.…”

Pelvic Floor Awareness and Adult Re-Toilet Training in the Treatment of Lower Urinary Tract Dysfunction

“…Childhood dysfunctional voiding may predict adult bladder control problems particularly in women with urge incontinence [12]. Pelvic floor disorders and LUTs are approximately doubled in nulliparous women with a history of childhood bedwetting [13]. Nocturnal enuresis in childhood is predictive of nocturia and frequency in adult women [14].…”