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The effect of obesity on treatment efficacy in children with nocturnal enuresis and voiding dysfunction
Ahmet Guven1, Karla Giramonti, Barry A Kogan
1Division of Urology, Section of Pediatric Urology, Albany Medical College, Albany, New York 12208, USA.
Insights
Obesity in children with voiding issues, like nocturnal enuresis, is linked to poorer treatment outcomes. Higher body mass index correlates with reduced treatment effectiveness and lower diary completion rates.
Area of Science:
- Pediatric Urology
- Public Health
- Pediatric Endocrinology
Background:
- Obesity is a significant public health issue in the U.S.
- Previous research indicates a high prevalence of obesity in children with dysfunctional voiding and nocturnal enuresis.
Purpose of the Study:
- To investigate the relationship between body mass index (BMI) and treatment efficacy in pediatric patients with voiding dysfunction.
- To determine if obesity impacts treatment outcomes for nocturnal enuresis and dysfunctional voiding.
Main Methods:
- Retrospective review of 250 pediatric patients diagnosed with nocturnal enuresis or dysfunctional voiding (2004-2005).
- Evaluation of bladder/bowel symptoms, urinary diary data, and BMI percentile.
- Correlation analysis between BMI percentile and treatment response.
Main Results:
- 38% of patients had nocturnal enuresis, 62% had dysfunctional voiding.
- Half of the patients had a BMI at or above the 85th percentile.
- Higher BMI correlated with reduced treatment response rates (65% normal BMI vs. 35% high BMI for voiding dysfunction).
- Patients with normal BMI had fewer nocturnal accidents and higher urinary diary completion rates.
Conclusions:
- Obesity is associated with diminished treatment efficacy in children with nocturnal enuresis and dysfunctional voiding.
- Higher BMI negatively impacts treatment success and patient adherence to monitoring tools like urinary diaries.
Purpose:
Obesity continues to be a leading public health concern in the United States. Our previous studies have suggested that there is a high rate of obesity in children with dysfunctional voiding, especially nocturnal enuresis. We investigated the correlation between body mass index and the efficacy of treatment in obese patients.
Materials And Methods:
We evaluated retrospectively records from patients seen with a diagnosis of nocturnal enuresis or dysfunctional voiding between January 2004 and July 2005. Bladder and bowel symptoms and urinary diary data were evaluated, and body mass index percentile was determined. Response to treatment was evaluated and correlated with body mass index percentile.
Results:
We evaluated 250 children, of whom 96 (38%) had nocturnal enuresis and 154 (62%) had dysfunctional voiding. Body mass index was normal in about half of the patients, and half were above the 85th percentile for body mass index. Patients with a body mass index above the 85th percentile had a reduced response to therapy. After treatment patients with a normal body mass index had a lower nocturnal accident frequency than those above the 85th percentile. Similarly, in those with voiding dysfunction the response rate was 65% in association with a normal body mass index vs 35% with a high body mass index. Furthermore, patients with a normal body mass index had a significantly higher rate of completing a urinary diary compared to those with a high body mass index.
Conclusions:
Obesity correlates with a lower voiding diary completion rate and lower efficacy of treatment in children with nocturnal enuresis or dysfunctional voiding.
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