The epidemiology of childhood incontinence

Aims To review studies on the comorbid psychological symptoms and disorders in patients with lower urinary tract disorders (LUTD) over the life‐span, to analyse how they contribute toward the aetiology of LUTD and to discuss optimal service implementation. Materials and Methods A review of relevant literature was conducted and presented during the ICI‐RS meeting in 2018. Open questions and future directions were discussed. Results On the basis of current research, there is overwhelming evidence in all age groups that psychological comorbidities are more common in patients with LUTD. Vice versa, patients with psychiatric disorders have higher rates of LUTD. The types of LUTDs and psychiatric disorders are heterogeneous. Complex aetiological models best explain specific associations of comorbidity. Irrespective of aetiology, it is advisable to address both urological and psychological issues in patients of all age groups with LUTD. Conclusions Psychological symptoms and disorders play a decisive role in the development of LUTD in all age groups and need to be considered in the assessment and treatment of LUTD.

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“…NE is the most common disorder of the four, affecting 10% of 7‐year‐old children . It has a spontaneous remission rate of 15% per year.…”

Section: Resultsmentioning

confidence: 99%

“…DUI affects up to 6% of 7‐year‐old children, also with a spontaneous cure rate of 15% per year . The overall comorbidity rate is 20% to 40% .…”

Section: Resultsmentioning

confidence: 99%

Are psychological comorbidities important in the aetiology of lower urinary tract dysfunction—ICI‐RS 2018?

Gontard

Vrijens

Selai

et al. 2019

Neurourology and Urodynamics

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“…7 In typically developing children, the prevalence of NE, DUI, and FI are 10%, 6%, and 1% to 4%, respectively. 8 Prevalence of incontinence in children with ID is 38% for NE, 39% for DUI, and 30% for FI in 7-year olds, and still 19% to 20% in adults. 9 Further, the higher the level of ID, the higher the prevalence of incontinence.…”

Section: Introductionmentioning

confidence: 94%

“…FI is diagnosed according to ROME‐IV criteria in children aged 4 years and older when soiling occurs at least 1×/month after ruling out organic causes . In typically developing children, the prevalence of NE, DUI, and FI are 10%, 6%, and 1% to 4%, respectively …”

Section: Introductionmentioning

confidence: 99%

Incontinence and psychological symptoms in Phelan‐McDermid syndrome

Hussong

Wagner

Curfs

et al. 2019

Neurourology and Urodynamics

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Aims: Phelan-McDermid syndrome (PMD) is a congenital syndrome caused by a deletion on chromosome 22q13.3. About 600 cases have been identified worldwide. PMD is characterized by neonatal hypotonia, moderate/severe intellectual impairment, impaired expressive language, and typical dysmorphic features. Psychological symptoms as hyperactivity, attention problems, restlessness, and stereotyped-repetitive behavior were reported. The aim of the study was to assess incontinence and associated psychological problems in PMD.Methods: Forty-one individuals with PMD were recruited through a German support group (48.8% male; mean age 13.4 years; range, 4-55 years). Parents or caregivers completed the developmental behavior checklist (DBC), as well as the parental questionnaire: enuresis/urinary incontinence, including six questions on adaptive toileting skills. Results: Rates of nocturnal enuresis (NE), daytime urinary incontinence, and fecal incontinence were 86%, 73%, and 79%. Rates were similar in all age groups (children, teens, adults). Constipation was present in 19%. Forty-two percent of the sample had a clinically relevant DBC score, with adults more affected than teens. Persons with NE had significantly higher "anxiety/depression" subscale scores. Toileting skills were more developed in adults than in children. Sixtyeight percent had further physical disabilities.Conclusions: Incontinence rates in PMD are high in all age groups. However, persons with PMD can improve their toilet skills. Therefore, the assessment and treatment of incontinence in persons with PMD is recommended. Constipation does not seem to be a major problem in PMD. Due to the high prevalence rates of somatic conditions, an assessment for organic and functional incontinence is recommended. K E Y W O R D S enuresis, fecal incontinence, Phelan-McDermid syndrome, psychopathology, urinary incontinence

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“…The Rome‐IV system differentiates further between functional constipation and nonretentive fecal incontinence . All types of incontinence are common among children: 10% of children are affected by NE, 6% by DUI and 1% to 3% by FI …”

Section: Introductionmentioning

confidence: 99%

Incontinence and headache in preschool children

Gontard

Overs

Moritz³

et al. 2019

Neurourology and Urodynamics

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Aims Headaches in preschool children are associated with behavioral and gastrointestinal symptoms. As the co‐occurrence with incontinence is not known in young children, the aim of the study was to examine associations of headache, psychological symptoms and nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI) in a population‐based sample of preschool children. Methods All preschool children of a defined geographical area were examined at school‐entry. Parents completed a 22‐item questionnaire, including 14 headache, 4 incontinence, and 25 items of the Strength and Difficulties Questionnaire (SDQ). Five hundred eighty‐five children (50.4% males) with a mean age of 5.8 years were included. Results In total, 27.2% of all children had headaches. 15.7% had secondary and 11.3% primary headaches. Five children had migraine and five tension‐type headaches, while all others were unclassifiable. 9.4% of children had incontinence (7.7% NE; 2.4% DUI, 1.2% FI) and 4.0% constipation. The rates of incontinence did not differ between children with primary and those without headache for NE (12.9% vs 7.5%), DUI (3.1% vs 2.7%) or FI (3.0% vs 1.0%), but for constipation (12.1% vs 2.6%). Incontinent children had significantly more behavioral and externalizing symptoms, children with headache more internalizing problems. Primary headache was a significant predictor for internalizing, while constipation and FI were predictors for externalizing symptoms. Conclusions This population‐based study showed that headache is associated with constipation, but not with incontinence in preschool children. Headache and incontinence are common risk factors for specific psychological symptoms and should be assessed in clinical practice.

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The epidemiology of childhood incontinence

Cited by 13 publications

References 64 publications

Are psychological comorbidities important in the aetiology of lower urinary tract dysfunction—ICI‐RS 2018?

Are psychological comorbidities important in the aetiology of lower urinary tract dysfunction—ICI‐RS 2018?

Incontinence and psychological symptoms in Phelan‐McDermid syndrome

Incontinence and headache in preschool children

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