A prospective longitudinal study to estimate the prevalence of obesity in Egyptian children with nocturnal enuresis and the association between body mass index and response to therapy

Abstract

Purpose: Nocturnal enuresis is defined as the involuntary voiding of urine in bed beyond the age at which bladder control is normally obtained. Previous studies have suggested a high rate of obesity in children with nocturnal enuresis. We evaluated this hypothesis and investigated the correlation between body mass index and the efficacy of treatment.
Subjects and methods: This was a prospective–longitudinal study done on 180 children with primary mono symptomatic nocturnal enuresis. Urinary diary data and body mass index percentile were determined. Response to the treatment was evaluated statistically and correlated with body mass index percentile. Response to different modalities of the treatment were also statistically evaluated separately and correlated with the BMI. The statistical test used was ANOVA F-test.
Results: 22.7% of our patients with nocturnal enuresis were either overweight or obese (13.9% and 7.8% respectively) according to the Egyptian national growth charts. Therefore, the prevalence of overweight and obesity is not higher in children with nocturnal enuresis as compared to the overall prevalence in normal Egyptian children (14%). But when we adjusted these values according to the social class of our patients, the prevalence of obesity was higher than normal for children of low socioeconomic status. There was no significant correlation between response to standard pediatric urological interventions (behavioral therapy, alarm therapy, imipramine, desmopressin, oxybutynin and tolterodine) and the BMI of our patients. Also, there was no significant difference in the response or relapse rates to the different modalities of therapies in the groups of patients with different BMI.
Conclusions: Obesity correlates with high BMI in lower socioeconomic classes, but does not correlate with efficacy of the treatment in children with nocturnal enuresis.