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Related Experiment Videos

Bladder dysfunction in children with refractory monosymptomatic primary nocturnal enuresis.

C K Yeung1, H N Chiu, F K Sit

  • 1Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital.

The Journal of Urology
|August 24, 1999
PubMed
Summary

Children with treatment-resistant primary nocturnal enuresis often have bladder dysfunction, including small capacity and nighttime instability. Desmopressin can reduce wet nights, but symptoms often return after stopping the medication.

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Area of Science:

  • Pediatric Urology
  • Sleep Medicine
  • Urodynamics

Background:

  • Monosymptomatic primary nocturnal enuresis (SPNE) is common in children.
  • Refractory SPNE cases often present diagnostic challenges.
  • Underlying bladder dysfunction may contribute to treatment resistance.

Purpose of the Study:

  • To investigate bladder dysfunction patterns in children with SPNE refractory to standard treatments.
  • To correlate bladder dysfunction with sleep-arousal status.
  • To evaluate treatment response to desmopressin in this cohort.

Main Methods:

  • Evaluated 41 children (33 boys, 8 girls) with refractory SPNE.
  • Utilized daytime and continuous nighttime cystometry.
  • Performed electroencephalography (EEG) monitoring during sleep.

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  • Recorded daytime and nighttime urinary output.

    • Main Results:

    • Identified 5 patterns of bladder dysfunction, often associated with sleep disturbances.
    • All patients had smaller functional bladder capacity than age-expected.
    • 47% showed a >50% reduction in wet nights with desmopressin, with immediate relapse upon cessation.
    • Pattern 4 (obstructive pattern with detrusor hypercontractility) revealed urethral abnormalities in 7/8 boys.

    Conclusions:

    • Abnormal bladder function is prevalent in children with refractory SPNE.
    • Nocturnal enuresis can be the sole symptom of significant bladder dysfunction.
    • Desmopressin may offer symptomatic relief despite underlying dysfunction, highlighting the need for tailored management strategies.