[Videourodynamic findings in the child with enuresis]

Videourodynamic investigation was carried on 62 patients with enuresis (34 females, 28 males). Patients were all grouped in four different clinical types according to the International Continence Society: (Type I) monosymptomatic enuresis nocturnal (24 cases); (Type II) nocturnal and diurnal enuresis without daytime frequency (8 cases); Type III) nocturnal enuresis with daytime frequency (22 cases); (Type IV) nocturnal and diurnal enuresis with daytime frequency and/or urgency (8 cases). In children with monosymptomatic enuresis nocturnal the videourodynamic study revealed, in 85% of cases, a normal bladder; in only 17% of cases was observed a detrusor instability. In patients with Type II enuresis a normal bladder was observed in 6 cases, whereas in two a detrusor instability was present. Among the 22 patients with Type III enuresis, 13 cases (59%) had a detrusor instability, 3 cases (14%) had a vesicosfinteric dyssinergia and 6 (27%) had a normal activity. In this group of patients it was documented in 10 cases a trabeculated bladder together with a vesicoureteral reflux in 4 patients, meatal stenosis and bladder diverticula in other two cases. All patients with Type IV enuresis documented pathological data: detrusor instability in 4 patients, vesico-sfinteric dyssinergia in two and neurogenic non-neurogenic bladder in the other two cases. A severe trabeculated bladder was present in all this cases, with vesico-ureteral reflux in two patient. Maximum cystometric capacity was low in 41 cases (66%), normal in 20 (32%), high in 1 (2%), independently of the types of enuresis.