Prevalence of nocturnal enuresis among Chinese children and adolescents: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Wen ¹ , WANG Zhe ² , JIANG Haoran ³ , WANG Mingyue ⁴ ,  ZHENG Sanxia ⁴

1. The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250355, P. R. China;
2. Institute of Acumox and Tuina, Shandong University of Traditional Chinese Medicine, Jinan 250355, P. R. China;
3. College of Pediatrics, Henan University of Chinese Medicine, Zhengzhou 450046, P. R. China;
4. Department of Pediatrics, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, P. R. China;

Corresponding author：

ZHENG Sanxia, Email: zhengsanxiasd@126.com

Keywords：

Nocturnal enuresis; Prevalence; Meta-analysis; Children; Adolescents

DOI：

10.7507/1672-2531.202310169

Video：

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Objective To systematically review the prevalence of enuresis in Chinese children and adolescents. Methods A computer search was conducted for epidemiological research on the prevalence of enuresis among Chinese children and adolescents in databases including CNKI, WanFang Data, VIP, SinoMed, PubMed, Embase, and Web of Science. Two researchers independently carried out literature screening, data extraction, and quality evaluation. Meta-analysis was executed using R language, with baujat plots and subgroup analysis to investigate heterogeneity sources, and leave-one-out for sensitivity analysis. Results A total of 38 papers were included, encompassing 327 065 participants, with 18 392 children suffering from enuresis. The aggregate prevalence rate was 5.59% (95%CI 4.58% to 6.81%). The prevalence rate showed a significant decreasing trend with increasing age, with rates at ages 5, 12, and 18 being 12.30% (95%CI 9.96% to 15.11%), 2.07% (95%CI 1.68% to 2.56%), and 1.95% (95%CI 0.90% to 4.20%), respectively. The incidence rate in male children was higher at 6.36% (95%CI 5.49% to 7.36%) than that in female children at 4.30% (95%CI 3.57% to 5.16%). Using DSM-IV as the diagnostic criteria, the prevalence rate was 3.78% (95%CI 2.58% to 5.52%), while it was 5.99% (95%CI 4.75% to 7.52%) using ICCS as the criteria. Conclusion The prevalence of enuresis among Chinese children and adolescents is affected by factors such as region, age, gender, and diagnostic standards. The prevalence is higher in South China, decreases with age, and is significantly higher in males than in females.

Citation： WANG Wen, WANG Zhe, JIANG Haoran, WANG Mingyue, ZHENG Sanxia. Prevalence of nocturnal enuresis among Chinese children and adolescents: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2024, 24(9): 1052-1060. doi: 10.7507/1672-2531.202310169 Copy

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1. Austin PF, Bauer SB, Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the standardization committee of the International Children's Continence Society. Neurourol Urodyn, 2016, 35(4): 471-481.
2. Zhong S, Zhang L, Wang M, et al. Abnormal resting-state functional connectivity of hippocampal subregions in children with primary nocturnal enuresis. Front Psychiatry, 2022, 13: 966362.
3. Joinson C, Heron J, von Gontard A, et al. Early childhood risk factors associated with daytime wetting and soiling in school-age children. J Pediatr Psychol, 2008, 33(7): 739-750.
4. Barone JG, Hanson C, DaJusta DG, et al. Nocturnal enuresis and overweight are associated with obstructive sleep apnea. Pediatrics, 2009, 124(1): e53-e59.
5. Butler RJ. Impact of nocturnal enuresis on children and young people. Scand J Urol Nephrol, 2001, 35(3): 169-176.
6. Van Herzeele C, Vande Walle J. Incontinence and psychological problems in children: a common central nervous pathway. Pediatr Nephrol, 2016, 31(5): 689-692.
7. Palma PL, Marzuillo P, Di Sessa A, et al. From clinical scenarios to the management of lower urinary tract symptoms in children: a focus for the general pediatrician. Healthcare (Basel), 2023, 11(9): 1285.
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9. 汪张娟, 沈小钰, 殷蕾, 等. 上海市浦东新区5~18岁儿童与青少年夜遗尿症流行病学调查. 中华全科医学, 2023, 21(7): 1220-1223.
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12. 缪千帆, 李艳君, 徐虹, 等. 中国5~18岁人群遗尿症患病率的横断面调查. 中国循证儿科杂志, 2020, 15(2): 81-86.
13. 班彩霞, 陈伟平, 贝为武, 等. 南宁市5~6岁儿童遗尿症的流行病学调查. 广西医学, 2015, 37(6): 840-841.
14. 中国儿童遗尿疾病管理协作组. 中国儿童单症状性夜遗尿疾病管理专家共识. 临床儿科杂志, 2014, 32(10): 970-975.
15. 中华医学会小儿外科学分会小儿尿动力和盆底学组和泌尿外科学组. 儿童遗尿症诊断和治疗中国专家共识. 中华医学杂志, 2019, 99(21): 1615-1620.
16. 许传亮, 宋奇翔, 方祖军, 等. 儿童夜间遗尿症诊治指南. 中华泌尿外科杂志, 2015, 36(11): 801-805.
17. 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
18. 朱琳, 王羽晴, 张爱启, 等. 哈尔滨市5~17岁儿童单症状原发性夜遗尿症发病相关因素调查. 中国妇幼保健, 2021, 36(23): 5499-5502.
19. 韩中将, 文一博, 汪玺正, 等. 儿童原发性遗尿症不同亚型患病率调查. 中华小儿外科杂志, 2019, 40(12): 1118-1122.
20. 唐芳, 童方运, 瞿秋萍, 等. 长沙市中小学6~18岁儿童与青少年夜遗尿症的流行病学调查及分析. 国际泌尿系统杂志, 2021, 41(1): 104-106.
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22. 范典标, 孙节, 吴跃进, 等. 上海市金山区5~13岁儿童遗尿症流行病学调查. 公共卫生与预防医学, 2020, 31(1): 113-117.
23. 郭骏, 孔院容, 王金叶, 等. 黄冈市黄州区5~7岁儿童原发性遗尿症及其致心理障碍的流行病学调查分析. 实用预防医学, 2017, 24(5): 590-593.
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Chinese Journal of Evidence-Based Medicine

Prevalence of nocturnal enuresis among Chinese children and adolescents: a meta-analysis

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