Prevalence and incidence of urologic diseases before puberty

With the aim of raising awareness with regard to a 'forgotten' health problem and to achieve secondary preventative intervention by means of an early diagnosis, we carried out a study of the prevalence and incidence of urological disease before puberty on a sample of pre-school and school children aged 3, 6 and 9 years. 734 children were recruited from nursery and elementary schools in three different areas of the city of Sassari. Information regarding the nuclear family and any previous disease was obtained by means of a questionnaire previously distributed and explained to the parents. Subsequently, the children were submitted to a urological examination at their schools during school hours; some of them were submitted to more accurate diagnostic tests at the Institute of Clinical Urology of the University. The following diseases were found: preputial adhesion (11.7%), phimosis (8%), enuresis (5.3%), cryptorchism (3.2%), hypospadias (0.5%), varicocele (0.5%), urinary tract infections (0.4%), vesico-urethral reflux (0.3%) and polycystic kidney (0.3%). The same subjects were evaluated, as part of a longitudinal study, a year later. Among the children at nursery school (4 years), there was 1 new case of phimosis. Among the 7 year old age group there were 14 new cases of adhesions, 3 of phimosis, 2 of enuresis and 1 new case of urinary tract infection. Among the 10 year olds there were 3 new cases of varicocele, 2 of adherence, 1 of phimosis and 1 new case of enuresis. The data obtained from the transverse study confirm the marked frequency of urological disease in the age groups under study. The longitudinal study showed, among other things, that the first cases of varicocele occur at 10 years and that enuresis can arise for the first time at any age.