Aims of study 

This study has two major aims:

 

1.To evaluate the social and family situation, personal habits and micturition habits and the methods used for dry training in children by means of a questionnaire;

 

2.To compare the results in children with and without lasting problems of bladder control.

 

Methods

A questionnaire of 43 questions was developed:12 questions evaluate the family situation and the personal data of the child; 17 are about the micturition behaviour and about the methods used for dry training; 14 document eventual lasting bladder disorders. This questionnaire was answered at home, without help of the investigators, by parents of schoolchildren. Exclusion was the existence of a neurological disease.In order to test the reliability of the answering a large group of parents were asked to fill in the same questionnaire with an interval of 6 months. The correlation was evaluated with the Kappa test.Other analysis were done with non-parametric tests; p<0,05 was considered as statistically significant.

 

Results

A total of 140 questionnaires were obtained. The studied population was divided in 3 groups: Group A 50 children who had undergone a urodynamic test during the last 2 years. Group B 23 children who had bladder problems but no urodynamic test; only 6 of them had consulted a health carer. Group C 67 children without any symptoms.

 

Boys/girls distribution was similar in all groups. Their mean age was 11.5 years old.

In group A significantly more children had relatives in the previous generation with enuresis beyond the age of 7. More children in this group had cousins and nephews with continuing problems of bedwetting at the time of the interview.

In the symptom groups (A+B) the ability to take responsibility for personal hygiene and for homework was lower. A high number of children in these groups did not take part in any extra-scolar activity. No difference in level of class or school results were found and the family situation was identical in all groups.

 

The repeated answering proved very reliable (no level of agreement below 0.74 and most = 1).

Parents in the symptomfree group C seemed to start the dry-training earlier. Significantly more children were dry during the afternoon nap in group C at start. Parents from group C used less different methods than those from the symptom groups. In group C more parents did not insist when an attempt to void was unsuccessful, 3 % invited the child to push and 13 % opened the tap. In the symptom groups 25 % asked to push and 20 % opened the tap.

 

Parents in groups A+B were more ready to punish (17% compared to 1%).

We found a good correlation between LUT symptoms and bladder dysfunction.

It was surprising that 70% of the parents considered their children to be continent in spite of several leakages a day.

 

Conclusions

The questionnaire used in this study has given interesting data. There seems to be a very good correlation between real dysfunction and dysfunction suggested through questionnaire. Children with and without LUT problems would seem to be different in hereditary factors, general independence and the age when their training started.It is remarkable that many children with lasting problems of bladder control did not consult a health carer.