RE:
PREVALENCE AND ASSOCIATED FACTORS OF ENURESIS IN TURKISH CHILDREN
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CUNEYT OZDEN, OZDEM
L. OZDAL, SERKAN ALTINOVA, IBRAHIM OGUZULGEN, GUVENC URGANCIOGLU, ALI
MEMIS
Department
of Urology, Numune Education and Research Hospital, Ankara, Turkey
Int
Braz J Urol, 33: 216-222, 2007
To the Editor:
Authors
investigated the prevalence of nocturnal enuresis and associated factors
of enuresis in Turkish children. The response rate was 89% and overall
prevalence of nocturnal enuresis and diurnal enuresis were 17.5% and 1.9%,
respectively. Some factors were associated with enuresis. They concluded
that the prevalence of nocturnal enuresis in Turkish children was not
different form others and that families do not have sufficient attention
about enuresis.
First of all, it is hopeful to follow the
standardization of terminology of lower urinary tract function in children
and adolescents 1, to make it easier to compare studies and decrease confusion
among researchers. The report 1 recommended that the ambiguous term diurnal
enuresis should be avoided. Second, when conducting a questionnaire survey,
it must be important to use a validated and reliable questionnaire. The
major problem, here, is whether the questionnaire was a validated and
reliable one or not, to evaluate lower urinary tract symptoms in children.
Most of the questionnaire surveys have the same drawbacks as this one:
the use of un-validated questionnaires and no comparative data. Sureshkumar
et al. reported the validity and reliability of a questionnaire 2.
Third, there is no consensus about a simple
question that should complete the questionnaire; parents, children or
both? In general, it is not so straightforward to evaluate nocturnal enuresis
and overactive bladder symptoms accurately in children. For children,
it is too difficult to assess the presence of urgency and to count the
episodes of nocturnal enuresis and the frequency of daytime voiding. On
the other hand, as authors concluded, parents may be unable to report
their child’s frequency of daytime voiding, presence of urgency
and incontinence, and even episodes of nighttime urinary incontinence
until they have a chance to observe the child at home and complete a bladder
diary. A bladder diary could be an important adjunctive measure to objectively
assess these and other parameters.
In conclusion, terminology and a bladder
diary could be a useful tool when a questionnaire survey about lower urinary
tract symptoms in children was conducted.
References
1. Neveus T, von Gontard A, Hoebeke P, Hjalmas K, Bauer S, Bower W, et
al.: The standardization of terminology of lower urinary tract function
in children and adolescents: report from the Standardisation Committee
of the International Children’s Continence Society. J Urol. 2006;
176: 314-24.
2. Sureshkumar P, Cumming RG, Craig JC: Validity and reliability of parental
report of frequency, severity and risk factors of urinary tract infection
and urinary incontinence in children. J Urol. 2006; 175: 2254-62.
Dr.
Mitsuru Kajiwara
Department of Urology
Division of Frontier Medical Science
Hiroshima University, Hiroshima, Japan
E-mail: urokajiwara@yahoo.co.jp
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