Diagnosing daytime bladder symptoms in children with nocturnal enuresis: a comparison of brief parental questionnaire with in-depth, physician-elicited, assessment

J Paediatr Child Health. 2010 Nov;46(11):636-41. doi: 10.1111/j.1440-1754.2010.01821.x. Epub 2010 Aug 25.

Abstract

Aims: To assess the accuracy of brief parental questionnaire reporting of daytime bladder symptoms in children with nocturnal enuresis and compare with in-depth reporting elicited by physician assessment, for diagnosing monosymptomatic and non-monosymptomatic nocturnal enuresis.

Methods: A cross-sectional study of consecutive children attending an outpatient nocturnal enuresis clinic at a tertiary paediatric hospital participated in the study. Parents were asked to complete a questionnaire as part of routine assessment at their first visit which was compared with a detailed clinical assessment by the physician involving eliciting a thorough history from the parent and child.

Results: Parents of 585 children participated in the study (mean age 9.2 years, range 5.0-17.5 years). Sixty percent of children were males. There was poor agreement between initial parental reporting and physician diagnosis of monosymptomatic and non-monosymptomatic nocturnal enuresis (Kappa = 0.3, 95% confidence interval 0.21-0.37), mainly because parents underreport daytime incontinence and urgency compared with physician-elicited information (43% vs. 69% and 66% vs. 87%, respectively).

Conclusions: Parents underreport daytime symptoms by 20-25%. Reliance on a brief parental history without prompting by physicians for daytime symptoms for diagnosing type of nocturnal enuresis may be misleading and result in suboptimal management.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Diagnosis, Differential
  • Diurnal Enuresis / classification
  • Diurnal Enuresis / diagnosis*
  • Female
  • Humans
  • Male
  • Medical History Taking
  • New South Wales
  • Nocturnal Enuresis / classification
  • Nocturnal Enuresis / diagnosis*
  • Parents*
  • Physical Examination*
  • Reproducibility of Results
  • Severity of Illness Index
  • Surveys and Questionnaires