REFRACTORY PRIMARY NOCTURNAL ENURESIS AND URODYNAMIC STUDIES, IS IT MANDATORY?
DOI:
https://doi.org/10.17656/jsmc.10327Keywords:
Primary Nocturnal Enuresis, Urodynamic study, Bladder capacityAbstract
Background
Enuresis is another meaning of intermittent nocturnal incontinence. It is a frequent symptom in children, with a prevalence of 5-10% at seven years of age, and is considered among the most prevalent conditions in childhood.
Objectives
To detect any Urodynamic study findings in patients presented with refractory primary nocturnal enuresis.
Patients and Methods
A prospective study was done for fifty patients who presented with pure Primary bedwetting (Monosymptomatic), {26 males and 24 females}, their age ranges from (5 to 24 years), who attended the Urodynamic section in the Urology Department, for the period: November 2010 till December 2014 after taking Medico-legal consent from all of them and performing a complete assessment for the patients.
Results
Regarding Urodynamic Study, nine patients (18%) had typical study, 24 patients (48%) had Detrusor Over-Activity, eight patients (16%) had Detrusor Under-Activity, two patients (4%) had DSD (Detrusor-Sphincter Dys-synergia), three patients (6%) had Detrusor Spasticity and one patient had Sphincteric deficiency. Regarding combined findings: one patient had Detrusor Under-Activity with DSD, one patient had Detrusor Over-Activity with Spasticity, and one patient had Detrusor Over-Activity with DSD.
Regarding the bladder capacity, seventeen patients (34%) had average bladder capacity, 28 patients (56%) had small bladder capacity and five patients (10%) had large bladder capacity.
Conclusion
According to our results, a significant percentage of the primary nocturnal enuretic patients had some Neuropathic Bladder. Does it recommend that every patient presented with Monosymptomatic Refractory Primary Nocturnal Enuresis do a Urodynamic study as their initial assessment? Besides, to find the exact type of abnormality and manage accordingly as soon as possible.
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