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Medline ® Abstract for Reference 20

of 'Etiology and clinical features of bladder dysfunction in children'

Daytime urinary incontinence in primary school children: a population-based survey.
Sureshkumar P, Craig JC, Roy LP, Knight JF
J Pediatr. 2000;137(6):814.
OBJECTIVES: To determine the prevalence and severity of, and risk factors for, daytime urinary incontinence in children starting primary school.
DESIGN AND SETTING: Population-based cross-sectional survey of new entrant primary school children in Sydney, Australia.
METHODS: A random cluster sample of 2020 primary school children was surveyed by using a daytime incontinence questionnaire with known substantial repeatability (mean kappa = 0.70).
RESULTS: The questionnaire was returned for 1419 (70%) children with a mean age of 5.9 years; 16.5% of children had experienced one or more episodes of wetting in the last 6 months (mild), 2.0% had wet twice or more per week (moderate), and 0.7% were wet every day (severe) (overall prevalence of 19.2%). On multivariate analysis, recent emotional stress (odds ratio 5.7), a history of daytime wetting along the paternal line (odds ratio 9.3), and a history of wetting among male siblings (odds ratio 5.3) were independent risk factors for moderate to severe daytime wetting. Expressed as population attributable risk, 59% and 28% of moderate-severe and mild daytime wetting, respectively, can be attributed to these 3 factors. Only 16% of families with affected children had sought medical help.
CONCLUSIONS: Daytime urinary incontinence in the first year of primary school is more common than previously reported, and only a small proportion of affected children seek medical help. Emotional stress and family history are likely to be major causal factors.
Centre for Kidney Research, Royal Alexandra Hospital for Children, Sydney, Australia.