Risk factors and functional abnormalities associated with adult onset secondary nocturnal enuresis in women

Chendrimada K Madhu; Hashim Hashim; Doyo Enki; Marcus J Drake

doi:10.1002/nau.22912

Risk factors and functional abnormalities associated with adult onset secondary nocturnal enuresis in women

Neurourol Urodyn. 2017 Jan;36(1):188-191. doi: 10.1002/nau.22912. Epub 2015 Oct 16.

Authors

Chendrimada K Madhu¹, Hashim Hashim², Doyo Enki³, Marcus J Drake⁴

Affiliations

¹ Department of Women's Health and Bristol Urological Institute, Southmead Hospital, Bristol, England.
² Urodynamics Unit, Bristol Urological Institute, Southmead Hospital, University of Bristol, Bristol, England.
³ Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, England.
⁴ Bristol Urological Institute, Southmead Hospital, University of Bristol, Bristol, England.

PMID: 26473752
DOI: 10.1002/nau.22912

Abstract

Aims: The study aims to evaluate bothersome lower urinary tract symptoms (LUTS), risk factors, and associated functional abnormalities in women reporting adult onset secondary nocturnal enuresis (SNE), to help understand factors associated with SNE.

Methods: 12,795 women (age >18) attending a tertiary referral centre underwent a comprehensive standardized evaluation including urodynamic testing in accordance with the International Continence Society recommendations. Records of all patients reporting bedwetting while asleep were evaluated under various categories. Multiple logistic regression was used to identify statistically significant risk factors and urodynamic findings associated with SNE.

Results: The prevalence of SNE in women undergoing urodynamic testing for bothersome LUTS was 14.4% (1,838). High BMI (OR = 1.47, P < 0.001), cigarette smoking (OR = 2, P < 0.001), antidepressant usage (OR = 1.8, P < 0.001), neurological conditions (OR = 2.12, P < 0.001), and previous hysterectomy (OR = 1.19, P = 0.03) were significantly associated with SNE. Women with SNE significantly complained of overactive bladder (OAB) symptoms (OR = 1.65, P < 0.001) and slightly higher mean nocturia episodes (OR = 1.38, P < 0.0001). Low maximum urethral closure pressure (MUCP) (OR = 1.34, P < 0.0001) and detrusor overactivity incontinence (DOI) (OR = 1.75, P < 0.0001) were significantly associated with SNE. There was no significant association with the symptom of stress urinary incontinence (P = 0.264), urodynamic stress incontinence (P = 0.454) or detrusor overactivity (P = 0.231).

Conclusion: Women with adult SNE usually present with OAB symptoms. SNE is associated with high BMI, cigarette smoking, antidepressant use, and neurological conditions. DOI and a low MUCP are possible pathophysiological mechanisms in SNE. Neurourol. Urodynam. 36:188-191, 2017. © 2015 Wiley Periodicals, Inc.

Keywords: antidepressants; detrusor overactivity; secondary nocturnal enuresis; smoking; stress incontinence; urodynamics.

MeSH terms

Adult
Age of Onset
Aged
Antidepressive Agents / adverse effects
Body Mass Index
Female
Humans
Lower Urinary Tract Symptoms / complications
Lower Urinary Tract Symptoms / epidemiology
Middle Aged
Nervous System Diseases / complications
Nervous System Diseases / epidemiology
Nocturnal Enuresis / epidemiology*
Prevalence
Risk Factors
Smoking / epidemiology
Urinary Bladder, Overactive / complications
Urinary Bladder, Overactive / epidemiology
Urinary Incontinence, Stress / complications
Urinary Incontinence, Stress / epidemiology
Urodynamics

Substances

Antidepressive Agents