Long-term followup of children with nocturnal enuresis: increased frequency of nocturia in adulthood

Abstract

Purpose: We investigated the long-term prognosis of a cohort of children with nocturnal enuresis, and identified the prevalence of nocturia and persistent comorbid symptoms.

Materials and methods: A questionnaire was sent to 1,265 patients treated for nocturnal enuresis during childhood at our university hospital. We used a validated tool, the International Consultation on Incontinence Modular Questionnaire on overactive bladder and urinary incontinence, to evaluate the presence of current urological symptoms. Participants were also asked about treatment received for nocturnal enuresis, and their medical files were analyzed.

Results: A total of 516 patients (41%) returned the questionnaire. Mean age was 17 years, and 64% of patients were male. Current urgency, daytime frequency and urinary incontinence were reported by 17%, 8% and 25% of patients, respectively. During the period of nocturnal enuresis up to 60% of patients had concomitant daytime symptoms. Nocturia was reported by 182 participants (35%). Males comprised 56% of patients (101) with nocturia and 69% of patients (230) without nocturia. Prevalence of current daytime symptoms and incontinence was higher in patients with nocturia (p<0.001). Those with nocturia were older at resolution of nocturnal enuresis (p<0.001) and suffered more nonmonosymptomatic nocturnal enuresis (p<0.014).

Conclusions: About a third of patients experience nocturia, a fourth still report some kind of urinary incontinence, a fifth have regular urgency and a tenth have daytime frequency. Thus, resolution of nocturnal enuresis does not necessarily mean resolution of the underlying pathological condition. Some patients with nocturia who continue to suffer with bothersome symptoms might benefit from continuous treatment for the underlying condition.

Keywords: lower urinary tract symptoms; nocturia; nocturnal enuresis; prevalence.