An epidemiological study on enuresis in children of two elementary schools in Suwon / 소아과

Purpose: The purpose of this study was to investigate the prevalence of enuresis in association with voiding habits and socioeconomic status in elementary school children. Methods: A dynamic survey was done of 1,514 students from two elementary schools in Suwon, Korea in December 2006. Data regarding gender, age, height and weight, voiding habits, and monthly family incomes were gathered and analyzed to discover any correlation with the incidence of enuresis. The percentile value of height or weight was extrapolated from the standard population curve. Results: Among 1,514 children, 1,063 (70.2%) answered and returned the questionnaires. Overall, the prevalence of enuresis was 8.7% and there was no difference between the public (8.8%) and private school (8.7%). The family incomes of the students from the two schools differed greatly from each other, but there was no difference in the prevalence of enuresis between the two schools. Children with a habit of void-holding showed a higher prevalence of enuresis. No significant correlation was found between the prevalence of enuresis and the height and weight percentile of children. Experience with hospital visits was low among enuretic children (20.8%), suggesting that Korean parents tend to neglect treatment of enuresis for their children. The prevalence of enuresis decreased by 2.0% each year, as school children aged. Conclusion: The overall prevalence of enuresis among elementary school children in Suwon district was 8.7%. The 12.1% prevalence of enuresis at the seven years came down gradually, to be nil at the age of 13. Infrequent urination or void- holding was assumed to be one of the important factors causing enuresis in elementary school children.

Clinical Parameters Predicting Responsiveness to Treatment in Enuresis Patients

PURPOSE: We tried to find out the clinical parameters which predict the outcome of treatment in children with enuresis. METHODS: Enuresis patients who visited our hospital during 2003-2007 were included. Parameters such as age, gender, height, weight, minimal voided volume, maximal voided volume, maximum functional bladder capacity, frequency of voiding, urine S,G. before and after sleep were measured and an enuresis diary was also recorded. The reduction in wetting frequencies were classified into three groups; none( or =50%) during the 2 weeks of evaluation and behavioral therapy to the 'initial non-responders'. RESULTS: Parameters mentioned above showed no significant relation to the treatment outcome. The response rate during the 2 weeks of the evaluation period was 32%(49/151) [complete in 1.3%(2/151), partial in 29.6%(47/151)]. Two-months' treatment responses were complete in 14(40%), partial in 19(54.3%) and none in 2(5.9%) responders(n=35), while they were 10(13.5%), 46(62.2%) and 18(24.3%), respectively in the non-responders(n=73)(P<0.05). CONCLUSION: We suggest that initial 'responsiveness' can be used as a predictor for good treatment outcome in patients with enuresis.

A Case of Peritoneal Empyema in a Patient with Nephrotic Syndrome due to Medical Neglect

Nephrotic syndrome is a common chronic disease in childhood. Patients with nephrotic syndrome are at an increased risk of bacterial infections due to immunological changes secondary to proteinuria. Primary bacterial peritonitis is one of the most serious and common infectious complications. The rate of peritonitis is 2-6% and overwhelming infection still carries a mortality rate of 1.5%. We experienced a rare case of nephrotic syndrome complicated with severe peritonitis and peritoneal empyema in a 10-year old girl after 2 months of medical neglect by parents. Here we emphasize the importance of early detection and treatment of peritoneal infection in nephrotic syndrome.