The Effects of the Age Initiating Toilet Training on Urinary Continence and Voiding Function in Children.

Purpose: To report the effects of the age initiating toilet training on urinary continence and voiding function in children. Material and Methods: In three years, we enrolled 318 healthy kindergarteners. One of the parents completed the questionnaire including the age initiating and the duration of toilet training, the current status of daytime and nighttime continence, the age of attaining daytime and nighttime continence, Dysfunctional Voiding Symptom Score (10 parameters, score 0–3), and Bristol Stool Scale. All children underwent uroflowmetry and post-void residual urine (PVR) tests. Results: Finally, 235 respondents (106 boys/129 girls, mean age = 4.8 ± 0.9 years) were eligible for analysis. The mean age initiating toilet training was 24.4±8.4 months. Based on the age initiating toilet training, children were classified as Early (≦18months, n=67) or Late Group (>18 months, n=168). Early Group had higher rates of daytime and nighttime continence before 30 months of age than Late Group (89.6% vs. 42.9%, p<0.001 and 63% vs. 18.3%, p<0.001, respectively). Of 169 children achieved nighttime continence, the age attaining nighttime continence significantly correlated with the age initiating daytime and nighttime training. A trend of lower DVSS was observed in the Early Group. (3.8±3.6 vs. 4.7±3.3, p=0.08). There were no significant difference in the prevalence of repeat abnormal flow patterns and increased PVR (>20ml) between two Groups. Conclusions: Early toilet training was associated with early attainment of both daytime and nighttime continence. The children with early toilet training had normal voiding function and a trend of lower DVSS. [Copyright &y& Elsevier]