Related Experiment Videos
[Detection of uropathies in enuresis in children]
Insights
Daytime wetting and urinary urgency in children often indicate hidden obstructive uropathies. Surgical intervention for these conditions, such as posterior urethral valves, shows a high success rate in improving symptoms.
Area of Science:
- Pediatric Urology
- Urologic Oncology
- Pediatric Surgery
Context:
- Nocturnal enuresis with daytime symptoms warrants investigation for obstructive uropathies.
- Diagnostic protocols are essential for identifying underlying causes of lower urinary tract symptoms in children.
Purpose:
- To evaluate the diagnostic protocol for obstructive uropathies in children presenting with nocturnal enuresis and daytime symptoms.
- To assess the efficacy of surgical treatments for identified obstructive urethral uropathies.
Summary:
- A protocol involving voiding cystourethrogram, IVP, cystometry, and endoscopy was applied to 110 children (4-14 years) with nocturnal enuresis and daytime wetting/urgency.
- Obstructive urethral uropathy was diagnosed in a significant proportion of patients, with posterior urethral valves in boys and distal ring obstruction in girls being common.
- Surgical treatments, including endoscopic resection, resulted in good outcomes in 77% of patients treated for obstruction.
Impact:
- Daytime wetting and urinary urgency can be key indicators of potentially treatable obstructive uropathies in children.
- Early diagnosis and surgical management of obstructive urethral conditions can lead to significant improvements in patient outcomes.
- This study highlights the importance of a comprehensive diagnostic approach to pediatric lower urinary tract symptoms.
Abstract:
A protocol has been applied to all our patients consulting for nocturnal enuresis who also presented daytime wetting or urge to void, to rule out obstructive uropathies. Our protocol includes voiding cystourethrogram, IVP, cystometry and endoscopy. 64 females and 46 males, 4 to 14 year-old, were studied between 1980 and 1983. Obstructive urethral uropathy was ruled out in 37 females (58%) and 32 males (69%). The most common treatments in these patients were endoscopic resection (Bugbee) of posterior urethral valves in boys and resection of the distal ring in girls. All other associated diseases or malformations were treated according to their etiology. Results, analyzed through a questionnaire sent to parents, were good in 77% of the patients treated for obstruction. In conclusion we think that daytime wetting and urge to void are very frequently the emerging symptoms of a hidden uropathy, in most cases obstructing proximal or distal urethra. Surgical treatment can lead to a good cure rate.