Children presenting at UK community enuresis clinics: comparisons with hospital-based samples

Objective: This study compares the clinical and psychosocial characteristics and the treatment outcomes of bedwetting UK children presenting at a community enuresis service with those from studies conducted in hospital-based settings.

Material and Methods: Cluster stratification by clinic was applied to ensure that the population attending the 15 enuresis clinics selected was representative. Parents completed the maternal tolerance scale and children completed the impact of bedwetting and Coopersmith self-esteem scales. The electronic databases MEDLINE and CINAHL were searched for the years 1966-2002 for UK-based empirical studies conducted in children aged 5-16 years with nocturnal enuresis.

Results: Children in the community sample were younger and had more day-time wetting than the hospital-based population but did not have significantly lower self-esteem. The impact of bedwetting had the strongest relationship with the Coopersmith self-esteem score, followed by ethnicity and the maternal tolerance score (ß=-0A9, p< 0.001; ß = 2.83, p <0.001; and ß = 0.45, p-0.015; respectively).

Conclusion: Primary referrals to community enuresis services are younger and have more day-time wetting than those attending hospital-based clinics but the majority do not have low self-esteem. Ethnicity appears to be an important factor in evaluating the impact of wetting on the child.