Longitudinal Study of Bowel and Bladder Control by Day and at Night in the First Six Years of Life. I: Epidemiology and Interrelations between Bowel and Bladder Control

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Abstract
The development of bowel and bladder control by day and at night during the first 6 yr of life in 320 Swiss children in the Zurich longitudinal study (1955-1976) is described. A scoring system was used which included intermediate stages of control. With toilet-training started in 96% of the children during the 1st yr of life, bowel control was completed in 32% at age 1, in 75% at age 2 and in 97% at age 3. Complete bladder control by day and at night was established in none of the children at age 1, in 20% at ages 2 and 3, and in 90% at age 4. Complete bowel and bladder control by day and at night were found in 5% at age 2, in 11% at age 3, in 77% at age 4 and in 91% at age 6. The significant relationships between bowel control, bladder control during the day and bladder control at night (P < 0.001) demonstrate that the same developmental process acts in bowel and bladder control. Highly correlated to each other, first bowel control develops, then bladder control by day and finally bladder control at night. The relevance of these interrelations for toilet-training and for the management of enuretic and encopretic children is discussed.