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• W2054956870 abstract "No AccessJournal of UrologyUrotherapy and Bowel Dysfunction1 Jun 2004COMORBIDITY OF FUNCTIONAL URINARY INCONTINENCE AND ENCOPRESIS: SOMATIC AND BEHAVIORAL ASSOCIATIONS ALEXANDER VON GONTARD and ELKE HOLLMANN ALEXANDER VON GONTARDALEXANDER VON GONTARD More articles by this author and ELKE HOLLMANNELKE HOLLMANN More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000113228.80583.83AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Functional urinary incontinence and encopresis are common comorbid disorders in childhood. We analyze the specific somatic and behavioral symptoms associated with functional enuresis/urinary incontinence and encopresis when they occur together. Materials and Methods: A total of 167 consecutive children 5 to 10 year olds, with day and/or night wetting were examined prospectively with ultrasound, uroflowmetry, electroencephalography, the Child Behavior Checklist, Culture Fair Intelligence Test and ICD-10 child psychiatric diagnoses. Results: The main findings for the comorbid group (20 patients) with wetting and soiling were a significantly higher rate of daytime incontinence and micturition problems, thickened bladder walls and pathological electroencephalography. There were higher, although not significant, rates of previous urinary tract infections, antibiotic prophylaxis, residual volume and abnormal uroflow curves in this group. Behaviorally, hyperkinetic syndromes, and emotional and conduct disorders (according to ICD-10) were more common. Of the 20 patients 65% had a Child Behavior Checklist total score (greater than 90th percentile) in the clinical range. The externalizing, internalizing, delinquent and anxious/depressed problem scales were also significantly higher. Conclusions: This risk group requires detailed assessment and specific treatment. In addition to the symptomatic treatment of the wetting and soiling, many of these children are in need of specific behavioral, psychotherapeutic and pharmacological treatment. References 1 Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Washington, D.C.: American Psychiatric Association1994. Google Scholar 2 The ICD-10 Classification of Mental and Behavioural Disorders—Diagnostic Criteria for Research. Geneva: World Health Organisation1993. Google Scholar 3 : Night and day wetting among a population of three-year-olds. Dev Med Child Neurol1982; 24: 479. Google Scholar 4 : Die Entwicklung der Darmund Blasenkontrolle von der Geburt bis zum 18. Lebensjahr. Schweiz med Wochenschr1978; 108: 155. Google Scholar 5 : Studies on encopresis. Acta Paediatr Scand1966; 170: 1. Google Scholar 6 : Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood. Pediatrics1997; 100: 228. Google Scholar 7 : Is encopresis always the result of constipation?. Arch Dis Child1994; 71: 186. Google Scholar 8 : Lack of benefit of laxatives as an adjunctive therapy for functional nonretentive fecal soiling in children. J Pediatr2000; 137: 808. Google Scholar 9 : Psychological aspects of urinary incontinence and enuresis in children. Prog Pediatr Urol2002; 5: 135. Google Scholar 10 : Attentional dysfunction in children with encopresis. J Dev Behav Pediatr1993; 14: 381. Google Scholar 11 : Somatic correlates of functional enuresis. Eur Child Adolesc Psychiatry1999; 8: 117. Google Scholar 12 : Clinical behavioral problems in day and night wetting children. Pediatr Nephrol1999; 13: 662. Google Scholar 13 : Screening for urinary tract abnormalities among day and night wetting children. Scand J Urol Nephrol1990; 24: 181. Google Scholar 14 : Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington: University of Vermont1991. Google Scholar 15 : Constipation: a cause of enuresis, urinary tract infection and vesicoureteral reflux in children. Med Hypotheses1985; 17: 409. Google Scholar 16 : Constipation and reversible urinary tract abnormalities. Arch Dis Child1994; 70: 56. Google Scholar 17 : Constipation—a commonly unrecognized cause of enuresis. Am J Dis Child1986; 140: 260. Google Scholar 18 Fehlow P.: Zur Bedeutung der Elektroenzephalographie bei der körperlichen Untersuchung von Kindern mit Enkopresis. Praxis: Kinderärztl, vol. 59, p. 262, 1991 Google Scholar 19 : Functional encopresis: symptom reduction and behavioral improvement. J Dev Behav Pediatr1995; 16: 226. Google Scholar 20 : Randomised trial of biofeedback training for encopresis. Arch Dis Child1996; 75: 367. Google Scholar From the Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byvon Gontard A, Moritz A, Thome-Granz S and Freitag C (2018) Association of Attention Deficit and Elimination Disorders at School Entry: A Population Based StudyJournal of Urology, VOL. 186, NO. 5, (2027-2032), Online publication date: 1-Nov-2011.Burgers R, Liem O, Canon S, Mousa H, Benninga M, Di Lorenzo C and Koff S (2010) Effect of Rectal Distention on Lower Urinary Tract Function in ChildrenJournal of Urology, VOL. 184, NO. 4S, (1680-1685), Online publication date: 1-Oct-2010.Kuhn S, Natale N, Siemer S, Stoeckle M and von Gontard A (2009) Clinical Differences in Daytime Wetting Subtypes: Urge Incontinence and Postponed VoidingJournal of Urology, VOL. 182, NO. 4S, (1967-1972), Online publication date: 1-Oct-2009.Zink S, Freitag C and von Gontard A (2018) Behavioral Comorbidity Differs in Subtypes of Enuresis and Urinary IncontinenceJournal of Urology, VOL. 179, NO. 1, (295-298), Online publication date: 1-Jan-2008.Heron J, Joinson C, Croudace T and von Gontard A (2018) Trajectories of Daytime Wetting and Soiling in a United Kingdom 4 to 9-Year-Old Population Birth Cohort StudyJournal of Urology, VOL. 179, NO. 5, (1970-1975), Online publication date: 1-May-2008. Volume 171Issue 6 Part 2June 2004Page: 2644-2647 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsurinary incontinence stressencopresismental disordersflowmetryenuresisMetricsAuthor Information ALEXANDER VON GONTARD More articles by this author ELKE HOLLMANN More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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