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1677 Monosymptomatic and Non-Mono Symptomatic Nocturnal Enuresis: A Clinical Evaluation
  1. M Naseri1,
  2. M Hiradfar2
  1. 1Mashhad University of Medical Sciences
  2. 2Pediatric Surgery, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background Nocturnal enuresis is divided into mono-symptomatic nocturnal enuresis) MNE) and non mono-symptomatic nocturnal enuresis) NMNE. (This study was conducted to review clinical and ultrasonography findings in enuretic children, and compare organic and functional pathologies of lower urinary tract (LUT) in children with mono-MNE with those who have NMNE.

Methods 111 neurologically normal children with chief complaint of enuresis enrolled in the study including 60 boys and 51 girls, aged 5–17 years old, 43 (38.8) % with MNE and 68 (61.2) % with NMNE. Urine analysis, urine culture and kidney-bladder ultra sonography was done for all. Some patients underwent voiding cystoureterography (VCUG), urodynamic study (UDS), or both.

Results Patients were divided in to 3 groups: MNE, NMNE -daytime incontinence and NMNE+daytime incontinence. Constipation, encopresis and urge incontinence were significantly more frequent in patients with NMNE+daytime incontinence (p= 0.011, 0.003, 0.001 respectively). Bladder wall thickness was the most common US findings. One patient with MNE and 9 with NMNE+ daytime incontinence had vesico-ureteral reflux (VUR) (p=0.016).Posterior urethral valve was reported in one patient with NMNE. Evidences of bladder dysfunction were noted in about half of the patients who underwent UDS, with higher prevalence in cases with NMNE+daytime urinary incontinence (p=0.297). Bowel symptoms and VUR were significantly more prevalent in cases with NMNE +daytime incontinence.

Conclusion We recommend doing VCUG in enuretic children who have daytime incontinence. In addition our study revealed that symptoms suggestive of over active bladder are not good indicators for bladder dysfunction.

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