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Clinical differences in daytime wetting subtypes: urge incontinence and postponed voiding.
J Urol. 2009 Oct; 182(4 Suppl):1967-72.JU

Abstract

PURPOSE

Urge incontinence and voiding postponement are common subtypes of daytime wetting in children. We analyzed clinical and behavioral differences in children with urge incontinence, voiding postponement and healthy controls at 2 centers.

MATERIALS AND METHODS

A total of 49 consecutive children 5 to 13 years old with urge incontinence (22) or voiding postponement (27) who presented to the department of urology or child psychiatry were examined as well as 32 age and gender matched controls. Instruments included physical examination, sonography, uroflowmetry, urinalysis, a 48-hour bladder diary, the Child Behavior Checklist, a structured psychiatric interview and an intelligence test.

RESULTS

The incontinent group consisted of 28 boys and 21 girls with a mean age of 7.35 years. Controls included 13 girls and 19 boys with a mean age of 7.31 years. Incontinent children had a higher rate of pathological uroflow curves (33% vs 25%) and urinary tract infection (6% vs 3%), greater post-void residual volume (6.3 ml vs 3.8 ml) and a thicker bladder wall. Mean IQ was the same in the 2 groups (103). The Child Behavior Checklist showed that significantly more incontinent children had clinical total behavior (41% vs 9%, p <0.01), and externalizing (35% vs 0%, p <0.001) and internalizing (29% vs 6%, p <0.05) scores than controls. Also, more children with voiding postponement had total clinical scores than those with urinary incontinence (56% vs 24%, p <0.05). Of incontinent children 49% fulfilled the criteria for at least 1 ICD-10 psychiatric diagnosis vs 9% of controls (p <0.001). There were no differences between children recruited at the departments of urology and child psychiatry.

CONCLUSIONS

This study shows that urge incontinence and voiding postponement are significantly associated with somatic complaints and psychological abnormalities compared to a control population. Children with voiding postponement have more externalizing behavioral disorders. Children seen at urological departments carry the same psychiatric risks and require the same attention to behavioral problem diagnosis.

Authors+Show Affiliations

Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg/Saar, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19695641

Citation

Kuhn, Sissy, et al. "Clinical Differences in Daytime Wetting Subtypes: Urge Incontinence and Postponed Voiding." The Journal of Urology, vol. 182, no. 4 Suppl, 2009, pp. 1967-72.
Kuhn S, Natale N, Siemer S, et al. Clinical differences in daytime wetting subtypes: urge incontinence and postponed voiding. J Urol. 2009;182(4 Suppl):1967-72.
Kuhn, S., Natale, N., Siemer, S., Stoeckle, M., & von Gontard, A. (2009). Clinical differences in daytime wetting subtypes: urge incontinence and postponed voiding. The Journal of Urology, 182(4 Suppl), 1967-72. https://doi.org/10.1016/j.juro.2009.03.023
Kuhn S, et al. Clinical Differences in Daytime Wetting Subtypes: Urge Incontinence and Postponed Voiding. J Urol. 2009;182(4 Suppl):1967-72. PubMed PMID: 19695641.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical differences in daytime wetting subtypes: urge incontinence and postponed voiding. AU - Kuhn,Sissy, AU - Natale,Nicole, AU - Siemer,Stefan, AU - Stoeckle,Michael, AU - von Gontard,Alexander, Y1 - 2009/08/20/ PY - 2008/12/10/received PY - 2009/8/22/entrez PY - 2009/8/22/pubmed PY - 2009/10/30/medline SP - 1967 EP - 72 JF - The Journal of urology JO - J Urol VL - 182 IS - 4 Suppl N2 - PURPOSE: Urge incontinence and voiding postponement are common subtypes of daytime wetting in children. We analyzed clinical and behavioral differences in children with urge incontinence, voiding postponement and healthy controls at 2 centers. MATERIALS AND METHODS: A total of 49 consecutive children 5 to 13 years old with urge incontinence (22) or voiding postponement (27) who presented to the department of urology or child psychiatry were examined as well as 32 age and gender matched controls. Instruments included physical examination, sonography, uroflowmetry, urinalysis, a 48-hour bladder diary, the Child Behavior Checklist, a structured psychiatric interview and an intelligence test. RESULTS: The incontinent group consisted of 28 boys and 21 girls with a mean age of 7.35 years. Controls included 13 girls and 19 boys with a mean age of 7.31 years. Incontinent children had a higher rate of pathological uroflow curves (33% vs 25%) and urinary tract infection (6% vs 3%), greater post-void residual volume (6.3 ml vs 3.8 ml) and a thicker bladder wall. Mean IQ was the same in the 2 groups (103). The Child Behavior Checklist showed that significantly more incontinent children had clinical total behavior (41% vs 9%, p <0.01), and externalizing (35% vs 0%, p <0.001) and internalizing (29% vs 6%, p <0.05) scores than controls. Also, more children with voiding postponement had total clinical scores than those with urinary incontinence (56% vs 24%, p <0.05). Of incontinent children 49% fulfilled the criteria for at least 1 ICD-10 psychiatric diagnosis vs 9% of controls (p <0.001). There were no differences between children recruited at the departments of urology and child psychiatry. CONCLUSIONS: This study shows that urge incontinence and voiding postponement are significantly associated with somatic complaints and psychological abnormalities compared to a control population. Children with voiding postponement have more externalizing behavioral disorders. Children seen at urological departments carry the same psychiatric risks and require the same attention to behavioral problem diagnosis. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/19695641/Clinical_differences_in_daytime_wetting_subtypes:_urge_incontinence_and_postponed_voiding_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2009.03.023?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -