Prevalence of nocturnal enuresis and accompanying factors in children aged 7–11 years in Turkey B Gu ¨mu ¨s ¸ 1 , N Vurgun 2 , M Lekili 1 , A Is ¸can 2 , T Mu ¨ezzinog ˘lu 1 and C Bu ¨yu ¨ksu 1 Departments of Urology 1 and Pediatrics 2 , Celal Bayar University, Manisa, Turkey Gu ¨mu ¨s ¸ B, Vurgun N, Lekili M, Is ¸can A, Mu ¨ezzinog ˘lu T, Bu ¨yu ¨ksu C. Prevalence of nocturnal enuresis and accompanying factors in children aged 7–11 years in Turkey. Acta Pædiatr 1999; 88: 1369–72. Stockholm. ISSN 0803–5253 There has been limited epidemiological research about nocturnal enuresis in Turkey. The objec- tives of this study were to ascertain the prevalence of nocturnal enuresis and the epidemiological factors associated with this in Turkish children aged 7–11 y, living in Manisa. Included in the study were 2000 children from various primary schools in Manisa. Parents were asked to fill out our specially designed questionnaire. In all, questionnaires for 1703 children were completed and returned to the department (871F, 51.1%; 832M, 48.9%). The prevalence of nocturnal enuresis for females was 10.6%, for males it was 16.9% and the overall prevalence was 13.7%. The prevalence of nocturnal enuresis decreased with age. Enuresis nocturna was found to be more common in children with a family history of bedwetting (76.5%). Deep sleeping, poor toilet habits and low educational level of the family were associated with enuresis. Consanguineous marriage did not influence the incidence of enuresis nocturna. There was no difference between enuretics and non- enuretics with reference to breastfeeding, being firstborn or being right- or left-handed. In our opinion, enuresis is an important problem for both families and children in Turkey for which specific guidelines should be developed. Various methods have been tried in the treatment of enuresis because of its multi-factorial aetiology. Child, family and physician co-operating together achieve the best help to both child and family. & Enuresis, family characteristics, prevalence B Gu ¨mu ¨s ¸ , Department of Urology, Medicine School, Celal Bayar University, 45010 Manisa, Turkey (Tel. 90 236 2349070 (320), fax. 90 236 2370213, e-mail. uroloji@hastane.bayar.edu.tr) Nocturnal enuresis is defined as a child’s bedwetting, with no acquired or congenital urogenital defect, after 4–6 y of age (1). Enuresis is frequently diagnosed amongst schoolchildren and is an important psycho- social problem for both parents and children. The results of epidemiological studies in the literature have shown that the prevalence of enuresis is 15–30% in children >5-y-old. It has been reported that this percentage decreases with age (2). However, no aetiological factor has been clearly defined in most enuretic cases. Congenital abnormalities, infections or neurologic diseases may cause enuresis. Some pathophysiological studies explicating the basis have been published. The physiology of sleep, capacity and neurophysiology of the bladder, antidiure- tic hormones (ADH) and sodium and potassium levels excreted in urine have been recently investigated (3, 4). The effects of psychological factors are still unclear in these studies. Although enuretic children seem to have accompanying psychological problems, it must be investigated whether these problems are the results of enuresis or aetiological factors. Our aims in this study were to determine enuresis prevalence in Turkey, the effects of Turkish family characteristics on enuretic children and the relationship of enuresis to accompanying psychosocial factors. Methods We used a cross-sectional study design to determine the prevalence of enuresis in Turkey and to investigate its relationship to accompanying psychosocial factors. This study was carried out in Manisa, a semi-indus- trialized city in the west of Turkey, with a population of 205 000. Manisa was selected for practical and financial reasons as the target working area, and the study base was defined as the child population from 7–11 y. A questionnaire particularly prepared for this study was posted to the parents of 2000 primary schoolchildren. The schools were selected from two different socio- economic regions of Manisa. The numbers of children included in the study from these two areas were almost equal (841 vs. 862 children). This questionnaire consisted of two parts: 20 ques- tions in the first part for all children and 9 questions in the second part for enuretic children only. The questions in the first part asked about sex, age, degree of  Scandinavian University Press 1999. ISSN 0803-5253 Acta Pñdiatr 88: 1369±72. 1999