Family primary nocturnal enuresis (FPNE), also known as hereditary nocturnal enuresis, means that there have been patients with primary enuresis in their immediate family members now or in the past, and families often have the phenomenon of nocturnal enuresis accumulation, which has a serious impact on the psychology and daily life of children and family members. In recent years, there are few studies on the clinical characteristics, emotional and behavioral problems of enuresis children with positive family history. The purpose of this study is to investigate the clinical characteristics and the effects of emotional and behavioral problems in children with familial aggregation of PNE, providing a reference basis for the treatment of children with FPNE.

A total of 306 children aged 5-16 years with primary nocturnal enuresis who were treated in the nocturnal from September 2020 to August 2022 were collected. The inclusion criteria were as follows: (1) the age was 5-16 years old; (2) involuntary urination during sleep was more than once a week for more than 3 months; (3) nocturnal enuresis from childhood and no bed-wetting period for more than 6 months; (4) informed consent and voluntary participation of the family members of the patients. Exclusion criteria: (1) neurological diseases or anatomical malformations of the urinary system; (2) history of urinary surgery; (3) other diseases that may cause secondary nocturnal enuresis, such as diabetes, diabetes insipidus, tethered cord syndrome and so on. Children with PNE were divided into familial primary  nocturnal enuresis group (FPNE group, n = 45) and sporadic primary  nocturnal enuresis group (SPNE group, n = 261) according to whether three generations of family members were involved or not. The clinical characteristics, emotional and behavioral changes of FPNE group were analyzed.

The incidences of severe NE、non-monosymptomatic nocturnal enuresis (NMNE).、abnormal stool and nocturnal micturition ≥ 2 times in the FPNE group were (68%、75%、48% and 42%, respectively)significantly higher than the sporadic enuresis group (SPNE group) (35%、47%、24% and 11%, respectively). The number of enuresis children aged 13-16 years old in FPNE group was 44.4% (20/45), which was significantly higher than 19.2% in the SPNE group(50/261) (P < 0.05). In the FPNE group, 46.7% (21/45) children were autosomal dominant, 33.3% (15/45) children were autosomal stealth inheritance, and 20.0% (9/45) children showed polygenic inheritance. The total scores of emotional symptoms、hyperactivity symptoms and difficulties in the FPNE group were higher than those in the SPNE group(P < 0.05). There was no significant difference in the scores of conduct problems, peer communication and society between the two groups(P＞0.05).Multiple linear regression analysis showed that age, poor academic performance and high total score of PSQ were the influencing factors of emotional symptoms in children with FPNE. Poor academic performance, abnormal stool, bladder dysfunction and high total score of PSQ were the influencing factors of hyperactivity symptoms in children with FPNE.

The nocturnal enuresis symptom of SPNE group is more serious, and the incidence of bladder dysfunction and abnormal stool is higher. The inheritance mode of FPNE children is mainly autosomal dominant inheritance, followed by chromosome stealth inheritance, and finally polygene inheritance. The incidence of psychological and behavioral abnormalities in children with FPNE is high, and there are many influencing factors.

There are many ways of inheritance of FPNE, among which autosomal dominant inheritance is the most common, the incidence of emotional symptoms and hyperactive symptoms is high, and the clinical symptoms are more serious, the risk of frequent and urgent urination is higher, and it is not easy to cure with age.