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Rectal diameter assessment in enuretic children-exploring the association between constipation and bladder function.

Emil Jansson1, Tryggve Nevéus2

  • 1a Department of Internal Medicine , Avesta Hospital , Avesta , Sweden.

Upsala Journal of Medical Sciences
|September 5, 2018
PubMed
Summary

In enuretic children, rectal dilation due to constipation did not correlate with voiding chart findings. This suggests complex interactions or limitations in assessing bladder dysfunction in children with enuresis.

Keywords:
Constipationdetrusor overactivityenuresisrectal diametervoiding chart

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Area of Science:

  • Pediatric Urology
  • Gastroenterology
  • Nephrology

Background:

  • Detrusor overactivity and constipation frequently coexist in children experiencing enuresis.
  • Constipation is a known contributing factor to detrusor overactivity.
  • The voiding chart and rectal ultrasonography are key tools for assessing bladder function and constipation, respectively.

Purpose of the Study:

  • To investigate the relationship between rectal diameter and voiding chart parameters in children with enuresis.
  • To determine if objective measures of constipation correlate with bladder dysfunction indicators in enuretic children.

Main Methods:

  • Retrospective evaluation of children with therapy-resistant enuresis.
  • Analysis of voiding charts (≥48 hours) and ultrasonographic assessment of rectal diameter (cutoff ≥30 mm).

Main Results:

  • 74 children (mean age 10.2 years) were analyzed; 35 had rectal dilatation.
  • No significant differences in voiding chart parameters, urgency, or daytime incontinence were observed between children with normal and dilated rectums.
  • Rectal dilatation was more prevalent in boys than girls (p=0.02).

Conclusions:

  • The lack of correlation may stem from counteracting mechanisms or the voiding chart's limitations in detecting detrusor overactivity.
  • Constipation and associated bladder dysfunction appear more significant in enuretic boys compared to girls.