Elsevier

Urology

Volume 76, Issue 1, July 2010, Pages 215-219
Urology

Voiding Function and Dysfunction
An Epidemiologic Study of Voiding and Bowel Habits in Korean Children: A Nationwide Multicenter Study

https://doi.org/10.1016/j.urology.2009.12.022Get rights and content

Objectives

To evaluate the prevalence of abnormal voiding and bowel habits in healthy children, and to identify possible relationships between personal and familial factors and voiding and/or bowel habits.

Methods

A randomly selected cross-sectional study was conducted in 19 240 children (5-13 years old) nationwide in the Republic of Korea. Parents were asked to complete questionnaires, which included items about nocturnal enuresis, daytime dysfunctional voiding symptoms (DVSs), and abnormal bowel habits (ABHs). Rates and associated factors were investigated.

Results

The overall rates of DVS, ABH, and of both were 46.4%, 31.3%, and 18.4%, respectively, and nocturnal enuresis was reported in 919 (5.6%). Daytime dysfunctional voiding symptoms were as follows: increased voiding frequency in 419 (2.5%), decreased voiding frequency in 720 (4.4%), urgency in 2740 (16.6%), daytime incontinence in 1854 (11.2%), urge incontinence in 2775 (16.8%), and holding maneuvers or postponed voiding in 3888 (23.5%). ABHs were as follows: constipation by frequency in 1103 (6.7%), constipation by the Bristol scale in 1941 (11.8%), fecal incontinence in 1293 (7.8%), and difficult or painful defecation in 2609 (15.8%). Delayed stool control, history of urinary tract infection, and a double-income family were positively associated with DVS or ABH or both. Furthermore, fathers with a low level of education and a low income were found to be associated with higher risk of ABH or DVS or both.

Conclusions

Delayed stool control, a history of urinary tract infection, a low paternal level of education, a double-income family, and a lower family income had a negative effect on voiding or bowel habits in children.

Section snippets

Material and Methods

A randomly selected cross-sectional study was conducted using a self-administered anonymous questionnaire in 26 kindergartens and 27 elementary schools nationwide in the Republic of Korea from October to December 2006. A total of 19 240 children aged 5-13 years of age were included in the study. Parents or guardians were asked to complete a questionnaire, which requested information on demographic factors, such as, date of birth, gender, school, address, age of attaining bladder and bowel

Results

We collected data on 16 516 children, 8260 boys, and 8256 girls (a response rate of 85.8%: 16 516/19 240).

Comment

Voiding and bowel dysfunction describes a wide spectrum of disorders that involve abnormal urinary or defecation patterns,7 which are not usually recognized before daytime bladder and bowel control have been achieved.8 Furthermore, available literature show an increase in the prevalence rates of voiding dysfunction over recent years.9, 10

A positive association between voiding and gastrointestinal disorders has been described in many articles.1, 2 Although many reports suggest a link between

Conclusions

The present study is the first large nationwide study on the prevalence of age-related voiding and bowel habits in Korea. The overall rates of DVS, ABH, and both in 5-13 years old children were found to be 46.4%, 31.3%, and 18.4%, respectively. Furthermore, the prevalence of enuresis in Korea was found to be similar to those reported in other Asian countries. This study demonstrates that delayed stool control, a history of UTI, a low paternal education level, a double-income family, and a lower

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