title: Monosymptomatic nocturnal enuresis caused by seasonal temperature changes.
abstract: BACKGROUND
  Primary nocturnal enuresis is the most frequent urologic complaint among pediatric patients. Enuresis is believed to have a complex etiology involving genetic, somatic, and behavioral factors. We study the relationship between seasonal temperature changes effect and monosymptomatic nocturnal enuresis (MNE).
  
  
  METHODS
  Between 2011 and 2012, a total of 75 children with primary MNE selected from urology and pediatry clinics were included in this study. All of the children underwent physical examinations, urine analyses, urinary ultrasounds, and direct urinary graphs. We evaluated the enuresis ratio for the summer (the hot season from June to September) and winter (the cold season from December to March) months in nightly, weekly, and monthly intervals via prepared questionnaires.
  
  
  RESULTS
  Of the 75 study participants, 45 were boys (60%) and 30 were girls (40%). The age range was 6-16 years (mean 10.3±2.0 years). We observed a difference in the ratio of enuresis data between the summer and winter months in 29 males and 19 females, which totals 48 of the 75 MNE patients evaluated in this study. There was a statistically significant difference noted in monthly enuresis ratio in the summer and winter (p<0.0001). We observed a significant difference in quality of life, and this difference caused considerable emotional discomfort for the patients.
  
  
  CONCLUSIONS
  In the winter months, the nightly, weekly, and monthly ratios are higher in children with MNE. This increase causes a decrease in the quality of life of these children.
authors: Deparment of Urology, Taksim Training and Research Hospital Taksim, Istanbul, Turkey.
authors: Tuncay
authors: T
authors: Tas
authors: Deparment of Urology, Hisar Intercontinental Hospital Umraniye, Istanbul, Turkey.
authors: Basri
authors: B
authors: Cakiroglu
authors: Deparment of Urology, Taksim Training and Research Hospital Taksim, Istanbul, Turkey.
authors: Aydin Ismet
authors: AI
authors: Hazar
authors: Deparment of Urology, Taksim Training and Research Hospital Taksim, Istanbul, Turkey.
authors: Mustafa Bahadir Can
authors: MB
authors: Balci
authors: Deparment of Urology, Maltepe University Medical School Maltepe, Istanbul, Turkey.
authors: Orhun
authors: O
authors: Sinanoglu
authors: Deparment of Pediatry, Hisar Intercontinental Hospital Umraniye, Istanbul, Turkey.
authors: Yunus
authors: Y
authors: Nas
authors: Deparment of Pediatry, Hisar Intercontinental Hospital Umraniye, Istanbul, Turkey.
authors: Fazli
authors: F
authors: Yilmazer
keywords: Cold weather; monosymptomatic nocturnal enuresis; predisposing risk factor; seasonal temperature