These studies were performed in six different countries (Turkey, Japan, USA, Colombia, England, Sweden). The ratio of male/female varied between studies, with a total of 3692 male subjects and 22,378 female subjects. Summaries of study design and outcomes measured from these eight studies are shown in Table 1. These studies, published between 20, were case–control or prospective cohort studies that connected the current history of nocturia to the childhood history of NE. The detailed retrieval process is shown in Figure 1. Based on selection criteria, 8 studies were identified, comprising 26,070 patients for the meta-analysis. After sorting through titles and abstracts, 19 studies were selected for full-text review. Our initial search identified 278 publications, and after the elimination of duplicates, 259 publications were available. Included studies must have NE occurring in childhood and nocturia occurring later in life.

In full-text screening, we excluded studies which were narrative reviews or had insufficient data. 18 We excluded studies which had comorbidities (eg spina bifida occulta), 19 only focused on animal cases, or did not discuss both childhood NE and nocturia in the title and abstract sorting. 15–17 We used the definition of one or more voids per night for nocturia. We focused on primary monosymptomatic NE, which is characterized by enuresis during sleep in children who have never achieved a satisfactory period of nighttime dryness and who lack symptoms of the lower urinary tract and/or daytime incontinence. Studies were included if they followed children with NE to see if nocturia occurred later in life (prospective cohort study) or if they tracked the history of NE in nocturia patients (case–control study). Two authors (SG and LK) independently screened articles for studies that met the inclusion criteria. This paper will also summarize common pathophysiologies in order to suggest treatment options and identify future areas of research. The goal of this paper is to conduct a systematic review and meta-analysis of studies investigating the relationship of NE of childhood to nocturia later in life. 10 Unfortunately, data are lacking on how and why NE transitions to nocturia a better understanding of the pathophysiology of NE and nocturia can be important for a targeted therapeutic approach. Additionally, previous studies have shown that children with NE are more likely to experience nocturia and lower urinary tract symptoms in adulthood. These overlaps and similarities in prevalence rates suggest a relationship between NE of childhood and nocturia of adulthood. 9 NE and nocturia both have the underlying pathophysiological mechanism of nocturnal polyuria and decreased nocturnal bladder capacity. 8 Although differences exist in the expression of NE and nocturia, there are many similarities in the etiologies, comorbidities, and treatment. The main dissimilarity between NE and nocturia is the presence of appropriate arousal resulting from bladder stimulation to cause awakening in nocturia. 7 Nocturnal polyuria, decreased nocturnal or global bladder capacity, and global polyuria have been proposed to be the main etiologies of nocturia. 7 It may reduce quality of life, productivity, and even cause physiological harm. 7 Nocturia is associated with elderly patients and increases with age up to a 50% prevalence in individuals older than 50. 6 Nocturia is present in over 15% of men and women between the ages of 20 and 40. Nocturia is a common but often neglected symptom of adulthood, defined as waking at night one or more times to void. Due to these similarities, there has been a suggestion that patients with childhood NE may go on to develop nocturia in adulthood. 2 Many of these underlying pathophysiological mechanisms are common to both NE and nocturia. 4 Sleep arousal disorders, nocturnal polyuria, and decreased nocturnal bladder capacity all play a role in the pathogenesis of NE. 3 In addition to subclinical effects on self-esteem, quality of life and distress, NE is also linked with an increased rate of comorbid clinical behavioral disorders. 2 There is a misconception that NE is a benign disorder and resolves spontaneously however, Yeung et al documented that in children with severe enuresis, the spontaneous resolution rate is only 50–60%. 1 This disease affects 10% of 7-year-olds but drops to a rate of 0.5% of adults. Nocturnal enuresis (NE) is a bothersome incontinence condition usually present in childhood and defined as the involuntary passage of urine during sleep in children over 5 years of age.

Nocturnal enuresis in adults causes