Childhood bedwetting linked to adult incontinence

Childhood bedwetting may be a predictor of bladder control problems later in life, according to a new study.

In a study of more than 1,000 Turkish women seen at one gynecology clinic, researchers found that those with Urinary Incontinence were more likely than other women to have had bedwetting problems as children.

The findings suggest that in some cases, a common cause may underlie both childhood and adult bladder problems, the study authors report in the British Journal of Urology International.

According to the researchers, the potential causes could include some flaw in the nerve pathway between the bladder and brain, or a developmental defect in the pelvic muscles or ligaments that help control the flow of urine.

Dr. Ayse Gurbuz, of the Zeynep Kamil Women and Children Disease Education and Research Hospital in Istanbul, led the study.

The cause of chronic bedwetting in school-age children is not fully clear, but it's thought to have a genetic component, since family history of the problem appears important. Urinary incontinence is commonly seen in women, and can arise from a number of causes, including weak or overactive bladder muscles. For some women, incontinence is related to childbirth or menopause.

To investigate whether the childhood and adulthood problems might be linked, the Turkish researchers surveyed 1,021 women seen at their center's gynecology clinic. Overall, 229 women said they wet the bed after the age of 5, and the childhood problem was more common among those who currently had urinary incontinence - 30 percent reported a history of bedwetting, versus 21 percent of those with no bladder control problems.

When the researchers focused on the different types of urinary incontinence, they found that childhood bedwetting was specifically linked to Stress incontinence, in which urine leaks from the bladder during exercise, heavy lifting or other activities that put stress on the organ. More than 35 percent of women with Stress incontinence wet the bed as a child.

In addition, nearly 6 percent of women with a history of bedwetting had Fecal Incontinence, versus just over 2 percent of those with no such history.

According to the researchers, the findings suggest that some congenital or developmental defect could be at work in some of these women. For example, they note, a problem in the collagen component of the pelvic muscles or ligaments could cause both delayed maturation of the structures involved in bladder control, and a vulnerability of these structures to weakness and injury later in life.

SOURCE: British Journal of Urology International, May 2005.