Abstract
Introduction
Nocturnal enuresis (NE) is an underreported symptom with a profound impact on quality of life. The primary objective of this study was to investigate the prevalence of NE and its association with other lower urinary tract symptoms (LUTS).
Methods
A validated pelvic floor questionnaire [electronic Personal Assessment Questionnaire–Pelvic Floor (ePAQ-PF)] was completed by 2302 women attending a urogynaecology clinic over a 3-year period. Association between NE and overactive bladder (OAB), stress incontinence (SUI) and nocturia was assessed using logistic regression. Subgroup analysis was performed on women with NE undergoing transvaginal tape (TVT). Ethical approval was acquired from the University of Sheffield and statistical analysis performed using SPSS version 22.
Results
The overall prevalence of NE reported in the cohort was 23 % (536 women). The reporting of NE was significantly associated with OAB (p < 0.005), SUI (p < 0.005) and nocturia (p < 0.005). Of 84 women undergoing TVT, 49 % reported NE preoperatively. These women reported significantly more severe symptoms of SUI and OAB (p < 0.05). Sixty percent reported improvement or cure of NE postoperatively, and this was dependent on improvement or cure of SUI (p < 0.005). The presence of NE was a negative predictor for improvement in symptoms of SUI following TVT (p = 0.037).
Conclusion
This study provides insight into NE, a commonly reported symptom in women attending urogynaecology clinics. To our knowledge, this is the first study to implicate stress incontinence as an important aetiological factor in women with NE. Further studies are required to better understand the aetiology of NE in adult women and relate this to management and outcome.
Similar content being viewed by others
References
Haylen BT, De Ridder D, Freeman RM, et al. An international urogynaecological association(IUGA/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21(5):5–26.
Hirasing RA, van Leerdam FJ, Bolk-Bennick L, Janknegt RA. Enuresis nocturia in adults. Scand J Urol Nephrol. 1997;31(6):533–6.
Austin PF et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization committee of the international Children’s continence society. J Urol. 2014;191(6):1863–5.
Yeung CK et al. Differences in characteristics of nocturnal enuresis between children and adolescents: a critical appraisal from a large epidemiological study. BJU Int. 2006;97(5):1069–73.
Yeung CK, Sihoe JD, Sit FK, Bower W, Sreedhar B, Lau J. Characteristics of primary nocturnal enuresis in adults: an epidemiological study. BJU Int. 2004;93(3):341–5.
Yeung CK, Sihoe JD, Sit FK, Diao M, Yew SY. Urodynamic findings in adults with primary nocturnal enuresis. J Urol. 2004;171(6):2595–8.
Madhu CK, Hashim H, Enki D, Drake M. Risk Factors and Functional Abnormalities Associated With Adult Onset Secondary Nocturnal Enuresis in Women. Neurourology and Urodynamics (epub ahead of print) 2015.
Schussler-Fiorenza R, Rose S, Gangnon R, Chewing B, Wald A. Increasing discussion rates of incontinence in primary care: a randomized controlled trial. J Womens’ Health (Larchmt). 2015;24(11):940–9.
Jones GL, Radley SC, Lumb J, Jha S. Electronic pelvic floor symptoms assessment: tests of data quality of ePAQ-PF. Int Urogynecol J. 2008;19:1337–47.
Bulchandani S, Toozs-Hobson P, Parsons M, McCooty S, Perkins K, Latthe P. Effect of anticholinergics on the overactive bladder and bowel domain of the electronic personal assessment questionnaire (ePAQ). Int Urogynecol J. 2015;26(4):533–7.
Dua A, Jones G, Wood H, Sidhu H. Understanding women’s experience of electronic interviewing during the clinical episode in urogynaecology: a qualitative study. Int Urogynecol J. 2013;24(11):1969–75.
Radley SC, Jones GL. Measuring quality of life in urogynaecology. Br J Obstet Gynaecol. 2004;111(1):33–6.
Abdel-Fattah M, Mostafa A, Young D, Ramsay I. Evaluation of transobturator tension-free vaginal tapes in the management of women with mixed urinary incontinence: one-year outcomes. Am J Obstet Gynecol. 2011;205(2):150.e1-6.
Goessaert AS, Everaert K, Hoebeke P, Kapila A, Walle JV. Nocturnal enuresis and nocturia, differences and similarities–lessons to learn? Acta Clin Belg. 2015;70(2):81–6.
Ciftci H, Savas M, Altunkol A, Oncel H, Yeni E, Verit A. The relations between enuresis in childhood and nocturnal polyuria in adult life. Int Neuro J. 2012;16:37–40.
Kamperis K, Rittig S, Jorgensen KA, Djurhuus JC. Nocturnal polyuria in monosymptomatic nocturnal enuresis refractory to desmopressin treatment. Am J Physiol Renal Physiol. 2006;291(6):1232–40.
Goessaert AS, Schoenaers B, Opdenakker O, Hoebeke P, Everaert K, Walle JV. Long-term follow-up of children with nocturnal enuresis: increased frequency of nocturia in adulthood. J Urol. 2014;191(6):1866–71.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Mr Stephen Radley is a Director and shareholder of ePAQ systems limited, an NHS spin-out technology company. The other authors declare they have no conflicts of interest.
Funding statement
No funding was received for this study.
Rights and permissions
About this article
Cite this article
Campbell, P., Li, W., Money-Taylor, J. et al. Nocturnal enuresis: prevalence and associated LUTS in adult women attending a urogynaecology clinic. Int Urogynecol J 28, 315–320 (2017). https://doi.org/10.1007/s00192-016-3099-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-016-3099-0