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Bladder capacity and renal concentrating ability in enuresis: pathogenic implications
T Nevéus1, T Tuvemo, G Läckgren
1Pediatric Section, Department of Women's and Childrens Health, Uppsala University, Uppsala, Sweden.
The Journal of Urology
|May 24, 2001
Summary
Children responding to desmopressin treatment for enuresis exhibit increased urine production, while non-responders show reduced bladder capacity, suggesting different underlying causes for bedwetting.
Area of Science:
- Pediatric Nephrology
- Urology
- Sleep Medicine
Background:
- Nocturnal enuresis affects a significant number of children, impacting quality of life.
- Understanding the pathogenesis of enuresis is crucial for effective treatment strategies.
Purpose of the Study:
- To investigate the pathogenesis of different types of enuresis by comparing bladder volume and renal concentrating capacity.
- To differentiate between desmopressin responders and non-responders based on physiological parameters.
Main Methods:
- A thirst provocation test was used to assess renal concentrating capacity in 55 dry children and 100 with enuresis.
- A 2-day voiding chart evaluated functional bladder capacity.
- Enuretic children were categorized into desmopressin responders (n=27) and non-responders (n=73).
Main Results:
- Desmopressin responders demonstrated lower renal concentrating capacity and higher daytime urine production compared to dry children and non-responders.
- Desmopressin non-responders exhibited significantly smaller functional bladder capacity relative to age compared to dry children and responders.
- Statistical significance (p<0.05) was observed for all main findings.
Conclusions:
- Children with enuresis who respond to desmopressin likely have nocturnal polyuria.
- Therapy-resistant enuresis in non-responders may be associated with detrusor hyperactivity and reduced bladder capacity.
- These findings support distinct pathophysiological mechanisms in different enuresis subtypes.