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Primary enuresis: a urodynamic evaluation
R Medel1, A C Ruarte, R Castera
1Urologic Unit Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina.
Insights
Primary enuresis type and bladder capacity indicate bladder dysfunction. Complicated primary enuresis (CPE) shows higher detrusor instability rates than monosymptomatic primary enuresis (MPE).
Area of Science:
- Pediatric Urology
- Urodynamics
- Child Health
Background:
- Primary enuresis, including monosymptomatic (MPE) and complicated (CPE) forms, affects children.
- Detrusor instability is a potential factor in primary enuresis.
- Identifying prognostic indicators is crucial for effective management.
Purpose of the Study:
- To evaluate urodynamic and clinical data for prognostic indicators of detrusor instability in primary enuresis.
- To compare the prevalence of detrusor instability between MPE and CPE.
- To determine if enuresis type and bladder capacity predict bladder dysfunction.
Main Methods:
- Retrospective review of 33 MPE and 47 CPE patients (ages 5-14).
- Urodynamic studies including cystometry to assess detrusor activity and bladder compliance.
- Comparison of urodynamic findings based on enuresis classification.
Main Results:
- Detrusor instability was found in 49% of MPE patients and 79% of CPE patients.
- Low bladder compliance was observed in one MPE and two CPE patients.
- Stable bladders were noted in 51% of MPE and 21% of CPE patients.
Conclusions:
- The type of primary enuresis is a significant indicator of bladder dysfunction.
- Maximum cystometric bladder capacity is a valuable prognostic marker for detrusor instability.
- CPE patients exhibit a higher likelihood of detrusor instability compared to MPE patients.
Objective:
To assess urodynamic and clinical data in patients with primary enuresis for potential prognostic indicators of detrusor instability.
Patients And Methods:
The records of 33 patients (mean age 8.8 years, range 5-14) with monosymptomatic primary enuresis (MPE, bedwetting as the sole symptom) and 47 patients (mean age 7.1 years, range 5-12) with complicated primary enuresis (CPE, bedwetting associated with diurnal urinary loss, squatting and urge incontinence) were reviewed. The children underwent urodynamic studies to detect detrusor instability and the prevalence was compared with the type of enuresis.
Results:
Of 33 patients with MPE, 17 (49%) showed either typical unstable detrusor contractions (16) or low-compliance bladders (one); in the remaining 16 patients, filling cystometry was normal and micturition was normal in all. Of the 47 patients with CPE, 35 (79%) showed detrusor instability and two decreased bladder compliance; the remaining 10 had stable bladders and micturition was also normal in all patients.
Conclusion:
The type of primary enuresis and the maximum cystometric bladder capacity were good indicators of bladder dysfunction.
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