Efficiency of enuresis prevention for 7-year-old children first entering school in the Russian Federation

Objective: To study the efficiency of enuresis prevention for 7-year-old children first entering school and having no experience of staying in preschool institutions.

Method: The following groups among 7-year-old children (mean age 7.2 ± 0.6 years) who had a planned prophylactic medical examination were formed by means of random sampling: Group A included children diagnosed with primary monosymptomatic enuresis (PMNE) at the age of 5-7 years, but in whom at the time of admission to school, sleep urinations were not observed. This group had alarm intervention as a prophylactic measure. Group B similarly included children who diagnosed with PMNE at the age of 5-7 years, and in whom at the time of admission to school, sleep urinations were not observed. However, in this group there was no alarm intervention. Group C included children in whom after the age of 5 years no episodes of sleep urination were observed. According to the recommendations of International Children's Continence Society (ICCS), enuresis was established in the event of at least two episodes of urinary incontinence per week and the duration of symptoms was at least 3 months. All these children were admitted to the first class of secondary school one month after the beginning of observation. Patients of all three groups were laboratory tested and had uroflowmetry and questionnaire survey with OAB-q SF. The study design was approved by the Ethics Committee of the Far Eastern Federal University. 

Results: Mean number of dry nights was markedly less in group B (4.5 ± 0.7) compared to groups A (6.2 ± 0.8) and C (6.6 ± 0.8). This was statistically significant (p<0.05). Mean number of enuresis episodes significantly increased in both groups A (p<0.05) and B (p<0.01) compared to group C at 1 month. However, at 3 months significant differences remained only for group В (p <0.05) compared to group C. The percentage of children having at least two episodes of enuresis per week for 3 months was 21.8% in group B compared with 5.7% in group C (p<0.05) and 6.8% in group A.

Conclusions: In this study, children without PMNE had a low risk of developing enuresis on school admission. In children with PMNE at the age of 5-7 years, who successfully overcame it and had no prophylactic alarm intervention, risk of developing enuresis on school admission was significantly higher than in children without PMNE. In children with PMNE at 5-7 years of age, who successfully overcame it and who had prophylactic alarm intervention, risk of developing enuresis on school admission did not differ significantly from that in children without PMNE.

Sri Lanka Journal of Child Health, 2017; 46: 33-38