P R E S S R E L E A S E
8 August 2000
Primary Nocturnal Enuresis (Bed-wetting) in Hong Kong:
"Old Problem: New Insights"
- Chronic endocrine disorders
Primary Nocturnal Enuresis (PNE), or bed-wetting, is an old and very common problem in childhood. In most western countries it has been estimated that about 20% of children by age 5 and 5-10% of children by age 7 are frequent bed-wetters. The traditional concept is that most cases are due to a developmental immaturity of voiding control. Hence an expectant, or observational, approach has been adopted by many parents and medical practitioners alike, with an assumption that the problem is completely harmless and will spontaneously disappear as the child grows older.
A large epidemiological study conducted recently by the Division of Paediatric Surgery, Department of Surgery, The Chinese University of Hong Kong, involving 15,000 local children and adolescents (aged 5 – 19 years) has revealed that 1.92% in total had bed-wetting. The study also found that frequent bed-wetters – who wet more than 3 nights per week – had a significantly higher chance of persistence of enuretic symptoms into later life than those less frequent bed-wetters. Furthermore, enuretic children had significantly more behavioral and psychological problems, as well as worse self-esteem, compared with normal non-enuretic controls. These adverse behavioral and psychological effects showed marked reversal to normal after successful cure of the bed-wetting.
Extensive research in the Division also showed that a large proportion
of the enuretic children had significant underlying bladder dysfunction
and sleep disturbances. This important recognition directly challenges
the long-established concept of perceiving PNE as due to a developmental
immaturity of voiding control, and casts doubts on the traditional wisdom
of expectant treatment. The findings have also led to a new classification
of PNE into different pathophysiological subtypes. Specific therapy
tailored to target at the underlying disturbances has now enabled us to
achieve a complete cure in nearly every patient, even for those with very
refractory symptoms.