Epidemiology
The prevalence of incontinence varies depending on age and whether the enuresis occurs during the day or at night. Daytime incontinence ranges from 3.2% to 9.0% in children aged 7 years, from 1.1% to 4.2% in those aged 11 to 13 years, and from 1.2% to 3.0% in adolescents aged 15 to 17 years. Nocturnal enuresis in the community decreases with age; in several geographical settings, including the United States, the Netherlands, and Hong Kong, the range is around 5% to 10% among 5-year-olds, 3% to 5% among 10-year-olds, and around 1% among individuals 15 years or older.[1]
It is more common in boys, with a 2:1 male to female ratio reported.[3][4] The disorder may also have higher prevalence in youth with learning disabilities or attention-deficit/hyperactivity disorder.[1]
The natural history of urine control is that most children are dry during the day before they are dry at night. The average age of toilet training has been rising for the last 50 years. In a prospective cohort study, median age of dryness during the day was 3.5 years, and median age of dryness at night was 4 years.[5]
In otherwise healthy adults aged 18 to 64 years, studies show a 0.5% prevalence of enuresis.[6] A report from the UK states that between 2% and 3% of 12- to 14-year-olds and 1% to 2% of people aged 15 years and older wet the bed twice a week on average.[7] European guidelines report that 7 out of 100 children wetting the bed at age 7 years will continue to have nocturnal enuresis into adulthood, emphasising the need for early treatment.[3] Given this substantial percentage of patients still affected into adulthood, vigilance is important in the treatment of children, because it is known that enuresis may have secondary implications, both for psychological health and future voiding health.[1]
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