[The evaluation of urinary tract dysfunction in children with monosymptomatic primary nocturnal enuresis]

Area of Science:

• Pediatric Urology
• Urodynamics
• Childhood Nocturnal Enuresis

Background:

• Urinary tract dysfunctions are common in children with enuresis.
• Monosymptomatic primary nocturnal enuresis often requires further investigation beyond initial non-pharmacological therapies.

Purpose of the Study:

• To estimate lower urinary tract function in children with monosymptomatic primary nocturnal enuresis resistant to non-pharmacological therapy.
• To evaluate the efficacy of pharmacological interventions for identified urodynamic disorders.

Main Methods:

• Urodynamic investigations (uroflowmetry and cystometry) were performed on 54 children aged 9-12 years.
• Children received behavioral therapy and short-term pharmacological treatment (desmopressin) prior to urodynamics.
• Pharmacological treatment (anticholinergic or Baclofen) was tailored based on urodynamic findings.

Main Results:

• Urodynamic disorders were detected in 44 out of 54 children.
• Overactive bladder was the most common disorder (34 children), followed by detrusor-sphincter discoordination (6 children) and decreased bladder capacity (5 children).
• 34 children achieved complete resolution of bedwetting, with varying treatment durations (3, 6, or 12 months).

Conclusions:

• Pharmacological treatment targeting urodynamic disorders is effective in managing monosymptomatic primary nocturnal enuresis.
• Tailored pharmacological interventions can significantly improve outcomes for children with enuretic symptoms and identified bladder dysfunction.