A pilot single center study in children with enuresis; exploring frequency and charecteristics of monosymptomatic and non-monosymptomatic nocturnal enuresis.

Background: Identifying clinical features that differentiate monosymptomatic nocturnal enuresis (MNE) from non-monosymptomatic nocturnal enuresis (NMNE) would aid in quick diagnosis, which would foster the introduction of early and appropriate therapeutic care options. The aim of this study is to determine whether patients with nocturnal enuresis have more daytime symptoms than reported in the literature.

Methods: In this retrospective study, patients aged 5-18 years who presented with complaints of nocturnal enuresis were evaluated. Patient records were reviewed for age, gender, daytime lower urinary tract symptoms, bladder capacity,family history of enuresis, Dysfunctional Voiding and Incontinence Scoring System scores, and history of urinary infections. MNE and NMNE were defined according to the International Children's Continence Society.

Results: A total of 629 patients, with a mean age of 8.6 ± 2.7, were included in the study. Of these, 53.7% were male. MNE was identified in 266 (42.2%) of the patients, with 363 (57.7%) were identified as having NMNE. Among the MNE patients, 65.4% were male, while 54.8% of the NMNE patients were female (p < 0.001). Patients were divided by age groups in the following manner: 5-7 (n = 272), 8-10 (n = 204), 11-13 (n = 116), and > 14 years old (n = 37). Of all NMNEs, 48.2% were in the 5-7 age group, 28.4% in the 8-10 age group, 16.5% in the 11-13 age group, and 6.9% > 14 age group (p = 0.006). NMNE was identified in 76% of female children aged 5-7 and 55% of males (p < 0.001). The most common lower urinary tract symptoms were daytime urinary incontinence (87.1%), which was present in 61.2% of females and 40.8% of males (p = 0.001). History of urinary system infection (17.1%) was more common in the NMNE group than the MNE group (6.4%) (p < 0.001). The frequency of family history was 54.5% in the MNE group and 35.3% in the NMNE group (p < 0.001).

Conclusion: This study showed that the majority of participants who presented with nocturnal enuresis had NMNE. Of particular note was the high frequency of NMNE observed in children aged 5-7 and in females.. These observations highlight the necessity of thoroughly questioning the symptoms of the lower urinary system in children with nocturnal enuresis.