title: Nocturnal enuresis in adolescents and adults is associated with childhood elimination symptoms.
abstract: OBJECTIVE
  Since nocturnal enuresis in adults and adolescents is rarely monosymptomatic, we identified the prevalence of childhood bladder and bowel dysfunction, and compared findings to those in a normative cohort.
  
  
  METHODS
  Childhood and current bladder and bowel dysfunction were investigated in 56 consecutive adolescents and adults attending a public nocturnal enuresis service and in 293 normative adults using a self-administered questionnaire. Analysis involved descriptive statistics, the chi-square and Kruskal-Wallis tests, and regression analysis with p <0.05 considered significant.
  
  
  RESULTS
  Adolescents and adults attending a public nocturnal enuresis service had significantly higher childhood scores than normative adults, and significantly more childhood urgency, frequency, urge incontinence, infrequent voiding and small volume, high urge voids. Infrequent bowel action and fecal soiling in childhood were also significantly more common in those with nocturnal enuresis than in controls. Adult symptoms of urge incontinence, general bowel symptoms and nocturnal enuresis were significantly more common in adults and adolescents with nocturnal enuresis. Significant associations were found between childhood symptoms and adult overactive bladder, and childhood emptying dysfunction and adult voiding dysfunction. Higher childhood scores in adults and adolescents with nocturnal enuresis correlated significantly with current adult symptoms of urge, urge leakage, stress incontinence, hesitancy, incomplete emptying and UTI within the last year.
  
  
  CONCLUSIONS
  Significant childhood bladder and bowel symptoms along with more adult urge and bowel dysfunction were found in adults and adolescents with nocturnal enuresis. The association with adult urgency and urinary tract infection supports the likelihood of underlying bladder and or voiding dysfunction in unremitting nocturnal enuresis.
authors.affiliation: Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. wfbower@hotmail.com
authors.forename: W F
authors.initials: WF
authors.lastname: Bower
authors.forename: F K Y
authors.initials: FK
authors.lastname: Sit
authors.forename: C K
authors.initials: CK
authors.lastname: Yeung
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D019960:Elimination Disorders / Q000150:complications*; D004775:Enuresis / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D014563:Urodynamics