الفهرس 
Introduction and aim of the work
Developmental Biology of Urinary Control in ChildrenOnly 14 pages are availabe for public view
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Abstract
Nocturnal enuresis is one of the most prevalent ailments of childhood & medically is considered to be a self-limiting disease with no major health risks. Although it rarely indicates the presence of organic disease, it may cause considerable distress to the child & thus many families consult their doctor. It may cause secondary emotional and social problems in children who continue to wet their beds (Van Tijen et al. 1998).
A number of aetiologic factors have been described to explain this phenomenon. It can indicate underlying problems which may be: benign (mostly): e.g. developmental delay in functional maturation of the CNS or, serious (rarely): e.g. urinary tract obstruction or psychiatric disturbances. However, despite extensive studies on enuresis, its epidemiology and aetiology remain obscure, and therapy for enuresis is disputed (Lee et al, 2000).
Assessment of an enuretic child should include : complete medical history, & complete physical examination. The obligatory laboratory investigation for enuresis is urinalysis (Oredsson et al, 1998). Nevertheless, in monosymptomatic enuresis, urinalysis may not be needed (Koff, 1998).
For the children seeking help there are several effective interventions, including behavioural measures, enuresis alarms & medication. These treatments are not suitable for all children & differ in their success rates, ease of use & side effects; none is totally effective. The doctor’s role is to identify any organic or psychological disorder & to help the child & parent choose the best course of action for their particular circumstances. A clear explanation of enuresis & treatment options is therefore an extremely important aspect of management (Evans, 1998).
Most existing descriptive epidemiology of enuresis gives no reliable foundation for analytic and interventional studies . Many prevalence studies of enuresis are flawed by imprecise definitions . The data are not analyzed routinely according to age and gender ,and only in rare cases daytime wetting , nocturnal enuresis and/or combined enuresis are analyzed separately. The epidemiological study of enuresis has not been reported in Assiut. thus: in this study we tried to assess the prevalence of primary nocturnal enuresis in children of the primary schools in Assiut city to know the actual extent of the problem and its associated factors. The study included psychiatric assessment.
Our study is a randomly selected cross-sectional study that was carried out from October, 2012 through March, 2013 on 3000 children in the primary school in Assiut. We selected 28 primary schools representing all social classes & all sectors in Assiut city. A self-administered questionnaire (prepared specifically for the study) was offered (with the co-operation of the teachers) to each child in the selected schools & completed voluntarily by the parents. Of the responders, nocturnal enuretics twice or more per month were considered as positive repliers & subjected to further evaluation including primary questioners and other including CBCL and pediatrics QL ( Parents form ) Data were analyzed using the Advanced Statistical Analysis Package (ASAP). Pearson chi-square tests were used to determine the statistical significance of differences between distributions of the categorical data.
The overall response rate to the questionnaire was 79%. The overall prevalence of enuresis was 20.2% (10.9% males & 9.3% females) with males slightly more than females. Marked enuresis (daily enuresis) was 53.7% of total enuretics. Of the nocturnal enuretic children 72.3% were primary enuretics & 27.7% were secondary enuretics. Of primary enuretics 52% had marked enuresis.
Most primary nocturnal enuretics were significantly observed among deep sleepers (65.7%), those with high father educational level (56%). Primary nocturnal enuresis was insignificantly associated with positive family history (14.9%). Enuresis was not affected by family size or birth rank. There was an effect on the family & the child in 41.7% and 36.6% respectively. Primary nocturnal enuretics were (53.7%) monosymptomatic.