title: Results of a questionnaire evaluating the effects of different methods of toilet training on achieving bladder control.
abstract: OBJECTIVE
  To analyse if family situation, personal habits and toilet training methods can influence the achievement of bladder control.
  
  
  METHODS
  A questionnaire with 41 questions was distributed to 4332 parents of children completing the last 2 years of normal primary school. The questionnaire had been tested for reproducibility of the answers in a random subgroup of 80 parents. The aims of the investigation were explained in an accompanying letter and the response rate was 76.7%. The result were analysed using the chi-square test (Yates corrected).
  
  
  RESULTS
  Two groups of children were identified, one with no lower urinary tract symptoms (3404) and one with complaints of daytime and night-time wetting, and urinary tract infections (928). The groups were termed the 'control' and 'symptom' groups, respectively. There were no differences in the family situation between the groups. The symptom group reported more 'below average' school results and less independence in homework and hygiene. The age at which toilet training started was significantly higher in the symptom group and scheduled voiding was used significantly less. The reaction of the parents when the attempt at voiding was unsuccessful was significantly different; in the control group most parents just postponed the effort and had the child try again later, whereas in the symptom group more parents asked the child to push, made special noises or opened the water tap.
  
  
  CONCLUSIONS
  These data show significant differences in toilet training between children with and with no lasting problems of bladder control. Postponing the onset of the training after 18 months of age and using certain methods to provoke voiding (asking to push, opening the water tap) probably increases the risk of later problems with bladder control.
authors.affiliation: Department Urology, University of Antwerp, Edegem, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Bakker
authors.forename: J D
authors.initials: JD
authors.lastname: Van Gool
authors.forename: M
authors.initials: M
authors.lastname: Van Sprundel
authors.forename: C
authors.initials: C
authors.lastname: Van Der Auwera
authors.forename: J J
authors.initials: JJ
authors.lastname: Wyndaele
mesh_terms: D017668:Age of Onset; D016009:Chi-Square Distribution; D002648:Child; D005192:Family Health; D006801:Humans; D008297:Male; D012008:Recurrence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014039:Toilet Training; D014549:Urinary Incontinence / Q000534:rehabilitation*; D014552:Urinary Tract Infections / Q000209:etiology