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Published on: August 25, 2014
Primary nocturnal enuresis: Assessment and treatment at a single referral center
Salvatore Arena1, Mario Patricolo2
1Unit of Paediatric Surgery, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy.
Insights
Nocturnal enuresis (NE) in Abu Dhabi is frequently linked to bladder dysfunction and constipation, particularly in girls. A comprehensive treatment strategy, including addressing constipation, effectively resolves NE in nearly 90% of cases.
Area of Science:
- Pediatric Urology
- Continence Management
- Bladder Dysfunction
Background:
- Investigated the prevalence of primary monosymptomatic nocturnal enuresis (PMNE) and non-monosymptomatic nocturnal enuresis (PNMNE).
- Examined associated factors in a major referral center for NE in Abu Dhabi.
Purpose of the Study:
- To determine the prevalence of different types of NE.
- To identify factors associated with NE in children.
- To evaluate treatment outcomes for NE.
Main Methods:
- Included 128 children referred to a Paediatric Continence Clinic (2014-2016).
- Excluded cases with specific urological, neurological, or psychiatric conditions.
- Follow-up was conducted for at least 6 months.
Main Results:
- Boys showed a higher incidence of PMNE (42.7%) compared to girls (8.7%).
- Girls had a higher incidence of PNMNE (91.3%) and dysfunctional voiding (DV).
- Constipation was present in 46% of patients; resolution rates for NE were 97% for PMNE and 86% for PNMNE.
Conclusions:
- NE in Abu Dhabi is often associated with bladder dysfunction or DV, predominantly in girls, and constipation.
- Dietary habits, climate, and urban stress may contribute to NE.
- A multimodal approach, including constipation management, achieved successful NE resolution in nearly 90% of cases.
Background:
The aim of this study was to investigate the prevalence of primary monosymptomatic and non-monosymptomatic nocturnal enuresis (PMNE and PNMNE) and associated factors in a major referral center for NE in Abu Dhabi.
Methods:
Children referred to the Paediatric Continence Clinic, between 2014 and 2016, for PNE were included in the study. Exclusion criteria were neuropathic bladder, abnormality of the bladder and bowel, urethral stenosis, neurological and psychiatric problems, non-completion of the diagnostic protocol, and follow up <6 months.
Results:
A total of 128 patients were included in the study: 82 boys (64.1%) and 46 girls (35.9%). A total of 42.7% of boys and 8.7% of girls had PMNE, and 57.3% of boys and 91.3% of girls had PNMNE. Constipation was present in 46% of patients. In the male PNMNE group, 74.5% had overactive bladder (OAB), 10.6%, dysfunctional voiding (DV); and 14.9%, OAB + DV. In the female PNMNE group, 35.7% had OAB; 21.4%, DV; 40.5%, OAB + DV; and 2.4%, underactive bladder. A total of 97% and 86 of children with PMNE and PNMNE, respectively, had resolution of NE. Boys had a significantly higher incidence of PMNE, and girls, of DV.
Conclusion:
In Abu Dhabi, NE is often associated with bladder dysfunction or DV, mostly in girls, and with constipation. High intake of dry, low fiber foods, along with hot weather and the stress of city living negatively affect the incidence of fecal retention and of NE. A multimodal approach, including the treatment of constipation, led to a satisfactory resolution of PNE in almost 90% of cases.
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