Factors Affecting Children's DUI in Mainland China and Its Relationship with Disposable Diaper Use

Wen J G1, Xu P C2, Wen Y B3, Wang X Z3, Wang Y H3, Li Z Z3, Shang X P3, Wang Q W3, Chen Y3, He Y L3, Jorgensen C4, Rittig S4

Research Type


Abstract Category

Overactive Bladder

Abstract 153
Open Discussion ePosters
Scientific Open Discussion Session 7
Wednesday 29th August 2018
12:30 - 12:35 (ePoster Station 9)
Exhibition Hall
Questionnaire Pediatrics Voiding Dysfunction Mixed Urinary Incontinence Incontinence
1. First Affiliated Hospital of Xinxiang Medical University, Pediatric Urodynamic Center of First Affiliated Hospital of Zhengzhou University, China., 2. Pediatric Urodynamic Center,First Affiliated Hospital of Zhengzhou University, Zhengzhou,China;International Joint Pediatric Urodynamic Laboratory Henan Province, China, 3. Pediatric Urodynamic Center,First Affiliated Hospital of Zhengzhou University, Zhengzhou,China, 4. Aarhus University Hospital

Jian Guo Wen




Hypothesis / aims of study
To investigate the prevalence of Daytime Urinary Incontinenc(DUI) among Chinese children aged 3 to 10 years and explore the Influencing factors, especially the use of disposable diapers(DD) after birth .
Study design, materials and methods
From October 2016 to May 2017,we used stratified sampling method, investigated the relationship of DUI and the using of DD in children aged 3 to 10, in 30 kindergarten and primary schools in one Province, China, by distributing 8900 questionnaires to the parents. Children with organic diseases that affect urination were excluded. Each school has a survey of no less than 200 people. The survey was conducted using a unified plan, survey procedures and questionnaires. The survey questionnaire was in anonymous form. It also conducted training in advance on the survey questionnaires for the staff of the schools surveyed, the survey questionnaire and the letter of investigation and explanation were sent to the parents of children and be collected on time. Each head teacher was responsible for organizing and supervising this investigation. The survey letter briefly described the significance of the survey and promised free advice on health issues. It was required that the number of investigations in each kindergarten or primary school should be over 95% of the number of persons required to be investigated, and the qualified rate of completing questionnaires should be more than 99%. Survey contents included: ①General information (gender, age, date of birth, etc.)②Use of DD after birth (whether DD was used, length of use, or adverse reactions during the use of urinary incontinence)③Voiding training (whether or not to perform voiding training, and when to start voiding training, etc.)④Current DUI conditions and problems related to voiding.Besides,the International Children's Urinary Control Association (ICCS) defined urinary incontinence as uncontrolled unintended outflow of urine due to loss of bladder function[1]. Urinary incontinence can be divided into daytime urinary incontinence (DUI) and nighttime urinary incontinence according to the time of occurrence. DUI was defined as non-controlled intermittent urinary leakage during the day [2] . It is generally believed that the ability of children aged 2 to 3 years to control urination during the day gradually develops and matures. Unless there is a congenital urinary tract malformation, DUI is usually diagnosed after 3 years of age[3].
A total of 8560 qualified questionnaires(96.2%) are collected and used for statistical analysis. The overall prevalence of DUI is 3.52%,ranging from 6.06% in aged 3-year old group to 1.82% in 10-year group. There is significant difference in prevalence between different age groups(χ2=75.690, P<0.001)and no difference is found between boys and girls(χ2=0.067, P=0.796)(Table1).With the longer the DD used, the more DUI is founded(=18.824, P<0.001),the incidence of DUI in children using DD less than 6 months is 2.48%, and when the DD are used in more than 24 months, the incidence of DUI increases by 4.25%. With the increasing frequency of using DD, the incidence of DUI increases( =9.234, P =0.002). With the delay in the voiding training(potty training), the incidence of DUI is increasing( =9.775, P =0.002),the incidence of DUI in children who start voiding training(potty training) within 6 months of birth is 2.12%. However, when the start of voiding training is 24 months later, the incidence of DUI increases to 5.85%. The long time using of diapers(OR=1.017 [1.006~1.027],P=0.002) and the increasing of using frequency of DD(OR=1.290[1.002~1.025],P=0.019)contribute to DUI significantly. Voiding training(potty training)within 6 months was a protective factor for DUI in children(OR=0.529 [0.345~0.811],P=0.003). (Table 2)
Interpretation of results
In addition to the increase of age causing the prevalence of DUI decreases in children, the long-term use of disposable diapers and the increased frequency of use can cause delays in voiding training(potty training). Then children have a relatively late ability to voluntarily control urination, as well as an increase of the incidence of DUI.
Concluding message
Long time using diapers and delay of voiding training are risk factors DUI in children.
Figure 1
Figure 2
  1. Austin PF, Bauer SB, Bower W,et al. The Standardization of Terminology of Lower Urinary Tract Function in Children and Adolescents: Update Report From the Standardization Committee of the International Children’s Continence Society[J]. Neurourology and Urodynamics, 2016,35(4):471-481.
  2. Swithinbank L V, Heron J, von Gontard A, et al. The natural history of daytime urinary incontinence in children: a large British cohort[J]. Acta Paediatr,2010,99(7):1031-1036.
  3. Vasconcelos MMA, East P, Blanco E,  et al.Early Behavioral Risks of Childhood and Adolescent Daytime Urinary Incontinence and Nocturnal Enuresis[J].Dev Behav Pediatr,2017,38(9):736-742.
Funding National Natural Science Foundation of China (No. 81370869); Key Project of International Cooperation of Science and Technology Department of Henan Province (No. 182102100001) Clinical Trial No Subjects Human Ethics Committee The Research and Clinical Trials Ethics Committee of the First Affiliated Hospital of Zhengzhou University, China Helsinki Yes Informed Consent Yes
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