Epidemiology survey and risk factor analysis of overactive bladder in children in Qingdao, China

OBJECTIVE: Explore the epidemiological characteristics and risk factors of overactive bladder (OAB) in children in Qingdao, China. METHOD: A stratified random cluster sampling method was adopted from 20 primary schools of Qingdao between September 2024 and June 2025. Data were collected through anonymous questionnaires, including basic information, lower urinary tract symptoms, Overactive Bladder Symptom Score, Pediatric Sleep Questionnaire (PSQ) and Strengths and Difficulties Questionnaire. Meanwhile, body mass index (BMI), history of nocturnal enuresis (NE), diaper use, urinary tract infection, constipation, and external genitalia development were collected. RESULTS: 3200 questionnaires were distributed, with 2986 valid ones recovered, including 1492 boys and 1494 girls. The morbidity of OAB was 5.86% (175/2986), with 7.24% (108/1492) in boys and 4.46% (67/1494) in girls, and the difference was statistically significant (P < 0.001). The morbidity of children over 9-year-old (4.45%, 77/1683) and those under 9-year-old (7.52%, 98/1303) was statistically significant (P < 0.001). NE history, urinary tract infection history, constipation, excessive use of diapers, boy with phimosis or redundant prepuce were independent risk factors. The scores of emotional symptoms, conduct problems, hyperactivity symptoms, peer relationship problems, total difficulty score, and total PSQ score in the OAB group were significantly higher than those of the non-OAB group, with statistically significant differences (all P < 0.05). CONCLUSIONS: Boys and children under 9-year-old are at higher risk of OAB in Qingdao. History of NE, urinary tract infection, constipation, excessive use of diapers, and a boy with phimosis or redundant prepuce are the main independent risk factors. Meanwhile, OAB significantly affects children's mental health and sleep quality.