Prevalence,risk Factors Of Primary Nocturnal Enuresis In Adolescents

BackgroundNocturnal enuresis（NE）can be classified as primary nocturnal enuresis（PNE）and secondary nocturnal enuresis（SNE）according to the International Children’s Continence Society（ICCS）guidelines.In recent years,due to the widespread use of disposable diapers and the reduction of toilet training for infants and young children,the prevalence of PNE has increased significantly.With the progress of society and people’s increasing attention to health,people pay more and more attention to PNE.The pathogenesis of PNE is not fully understood,and long-term enuresis can also have a negative impact on the psychosocial status of patients.This study aims to investigate the prevalence and risk factors of PNE in adolescents,and the Psychological effect of PNE on adolescents,to enrich the data of related studies in China,and to provide a reference basis for the health care and prevention of diseases in adolescents.ObjectivesThrough an epidemiological survey of PNE in adolescents aged 12-18 years to investigate the prevalence and risk factors of PNE in adolescents,and the Psychological effect of PNE on adolescents.MethodsFrom September 2020 to December 2020,a stratified,whole-group random sampling method was used to conduct an epidemiological survey of 6408 junior and senior high school students in a region of Henan Province.The survey included general information questionnaire;urinary frequency,urgency,and incontinence;recurrent urinary tract infection（RUTI）;Enuresis questionnaire;self-esteem scale and the Pittsburgh sleep quality index（PSQI）.PNE:Enuresis begins in early childhood,and involuntary urination occurs more than once a month at night after being older than 5 years old;BMI≥25 kg/m~2is considered to be overweight;The diagnostic criteria of RUTI is that bladder irritation symptoms such as frequent,urgency and pain have occurred in the past or now,and urinary tract infection has been diagnosed through urine test,and the frequency of bladder irritation symptoms occurred more than 2 times in the past6 months or more than 3 times in the past 12 months.The adolescents with severe organic disease,physical disabilities,incomplete questionnaires,and age less than 12 years or older than 18 years were excluded.SPSS 2 1.0 was used for statistical analysis.U test,chi-square test and binary logistic regression were used.Results1.A total of 7000 questionnaires were sent out and 6408（91.54%）were valid,including 3185 boys and 3223 girls.The survey showed that the prevalence of PNE among adolescents was 2.98%.The prevalence was 4.67%at the age of 12 and 1.37%at the age of 18,which decreased gradually with the increase of age.2.The prevalence rates were 2.96%and 2.99%in urban and rural areas,respectively,with no statistically significant differences（χ~2=0.004,P>0.05）.The prevalence of PNE was higher in boys than in girls,and the difference was statistically significant（χ~2=11.485,P=0.01）;the prevalence of PNE was higher in overweight adolescents than in normal weight adolescents,and the difference was statistically significant（χ~2=13.909,P<0.001）;the prevalence of PNE was higher in those with urinary frequency,urgency,and incontinence than in those without symptoms（χ~2=35.810,P<0.001;χ~2=22.958,P<0.001;χ~2=71.116,P<0.001）;the prevalence of PNE was higher among those with RUTI and family history of enuresis than in those without RUTI and family history of enuresis（χ~2=29.052,P<0.01;χ~2=65.674,P<0.01）.The results of logistic regression analysis showed that male（OR=1.677,P<0.05）,overweight（OR=1.842,P<0.05）,urgent urination（OR=1.676,P<0.05）,frequent urination（OR=1.919,P<0.05）,urinary incontinence（OR=3.493,P<0.001）,RUTI（OR=2.535,P<0.001）and family history of enuresis（OR=3.005,P<0.001）were all related to the risk of PNE.3.PNE patients had lower self-esteem scale scores than the non-PNE group scores（z=-3.097,P<0.05）and the Pittsburgh Sleepiness Index was higher in the PNE group compared with the non-PNE group（z=-5.456,P<0.05）.ConclusionsThe prevalence of PNE is high in adolescents and decreases gradually with age.Male,overweight,urinary frequency,urgency,incontinence,RUTI,and family history of enuresis are risk factors for PNE.PNE has a negative impact on self-esteem and sleep quality in adolescents.