UroToday.com - A study by Dr. Premala Sureshkumar et al. evaluated the risk spectrum and risk factors for diurnal enuresis in school-age children.

The group found that overall there was a poor concordance between frequency and amount of daytime incontinence. They also found that of children who wet with the least frequency during the day, almost half were more likely to experience the greatest amounts of incontinence in regards to volume. In those who experienced severe frequency, the majority (98%) reported very mild to moderate levels of amount of incontinence. They found that a definite UTI was much more strongly associated with frequency of daytime urinary incontinence in males than in females. Of course, constipation was associated with a stronger effect on daytime incontinence. The group acknowledged that the study did have limitations, the first one being a low response rate (35%). They also stated that their study was by no means establishing cure guidelines for incontinence. They feel that longitudinal studies will be necessary to further explore the relationships and associations of risk factors with daytime incontinence.

There was an editorial comment by Julian Wan stating that he had some concern with the data collection. He felt that 35% response rate could have been an over reporting. There was also some concern about how criteria was established such as, "does your child strain more than 25% of the time?" or "are there lumpy or hard stools more than 25% of the time"? He states that a more practical input to data can help clinical recommendations.

With the move forward to an electronic medial record keeping system, hopefully we can keep some of this data in a prospective manner. Nonetheless, the true task lies in how we establish the criteria to collect it prospectively.