Comorbidity of functional urinary incontinence and encopresis: somatic and behavioral associations.
OBJECTIVE
Functional urinary incontinence and encopresis are common comorbid disorders in childhood. We analyze the specific somatic and behavioral symptoms associated with functional enuresis/urinary incontinence and encopresis when they occur together.


METHODS
A total of 167 consecutive children 5 to 10 year olds, with day and/or night wetting were examined prospectively with ultrasound, uroflowmetry, electroencephalography, the Child Behavior Checklist, Culture Fair Intelligence Test and ICD-10 child psychiatric diagnoses.


RESULTS
The main findings for the comorbid group (20 patients) with wetting and soiling were a significantly higher rate of daytime incontinence and micturition problems, thickened bladder walls and pathological electroencephalography. There were higher, although not significant, rates of previous urinary tract infections, antibiotic prophylaxis, residual volume and abnormal uroflow curves in this group. Behaviorally, hyperkinetic syndromes, and emotional and conduct disorders (according to ICD-10) were more common. Of the 20 patients 65% had a Child Behavior Checklist total score (greater than 90th percentile) in the clinical range. The externalizing, internalizing, delinquent and anxious/depressed problem scales were also significantly higher.


CONCLUSIONS
This risk group requires detailed assessment and specific treatment. In addition to the symptomatic treatment of the wetting and soiling, many of these children are in need of specific behavioral, psychotherapeutic and pharmacological treatment.
Von Gontard
Alexander
A
Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany. von.gontard@uniklinik-saarland.de
Hollmann
Elke
E
D001526:Behavioral Symptoms / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D004688:Encopresis / Q000150:complications* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D014549:Urinary Incontinence / Q000150:complications* / Q000523:psychology*