Abstract
Amaç: Bu çalışmada uyku bozuklukları ile monosemptomatik enürezis nokturna (MEN) arasındaki ilişkinin araştırılması ve MEN'e neden olan olası etiyolojik faktörlerin değerlendirilmesi amaçlandı.
Gereç ve Yöntemler: Enürezis noktürna şikâyeti olan 50 hasta, Eylül 2012 ile Aralık 2013 tarihleri arasında ileriye dönük olarak değerlendirildi. Tüm olguların ayrıntılı incelemesi sonucunda ikincil organik nedenleri olan hastalar çalışma dışı bırakıldı. Ayrıntılı anamnez ve detaylı muayeneler neticesinde, primer MEN olduğu saptanan 34 hastaya (%68,0) bütün gece tam polisomnografi yöntemi ile uyku testi yapılarak kayıt altına alındı.
Bulgular: Çalışmada değerlendirilen elli hastanın yirmi dokuzuna (%85,3) farklı derecelerde obstrüktif uyku apne sendromu tanısı konuldu ve bu hastalar çalışmaya dâhil edildi. Elde edilen apne skor değerlerinin; hastaların yaşı, alt ıslatma sıklığı, vücut kitle indeksi ve mesane kapasitesi ile korelasyonu analiz edildi ve analizler sonucunda sadece apne skoru değerleri ile vücut kitle indeksi arasında istatistiksel olarak anlamlı pozitif korelasyon tespit edildi (r=0,384; p=0,047). Hastalar ek olarak ağırlık gruplarına ayrılarak apne skoru, alt ıslatma sıklığı ve mesane kapasitesi açısından karşılaştırıldı ve alt ıslatma sıklığı ile mesane kapasitesi açısından anlamlı farklılıklar tespit edilmezken; obez grubun ortanca apne skoru normal ve fazla kilolu gruplardan istatistiksel olarak anlamlı derecede yüksek bulundu (p=0,019).
Sonuç: Obezite ve obstrüktif uyku apne sendromu, MEN tanısı konan hastaların önemli bir kısmında mevcuttur ve bu iki hastalık, MEN gelişiminde etkili faktörlerdir.
Supporting Institution
Düzce Üniversitesi Bilimsel Araştırma Projeleri Koordinatörlüğü
Project Number
2012.04.03.102
References
- 1) Vande Walle J, Rittig S, Bauer S, Eggert P, Marschall-Kehrel D, Tekgul S. Practical consensus guidelines for the management of enuresis. Eur J Pediatr. 2012;171(6):971-83. doi: 10.1007/s00431-012-1687-7.
- 2) Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-78. doi: 10.1002/nau.10052.
- 3) Weaver A, Dobson P. Nocturnal enuresis in children. J Fam Health Care. 2007;17(5):159-61.
- 4) Jain S, Bhatt GC. Advances in the management of primary monosymptomatic nocturnal enuresis in children. Paediatr Int Child Health. 2016;36(1):7-14. doi: 10.1179/2046905515Y.0000000023.
- 5) Van Herzeele C, Dhondt K, Roels SP, Raes A, Hoebeke P, Groen LA, et al. Desmopressin (melt) therapy in children with monosymptomatic nocturnal enuresis and nocturnal polyuria results in improved neuropsychological functioning and sleep. Pediatr Nephrol. 2016;31(9):1477-84. doi: 10.1007/s00467-016-3351-3.
- 6) Choudhary B, Patil R, Bhatt GC, Pakhare AP, Goyal A, P A, et al. Association of Sleep Disordered Breathing with Mono-Symptomatic Nocturnal Enuresis: A Study among School Children of Central India. PLoS One. 2016;11(5):e0155808. doi: 10.1371/journal.pone.0155808.
- 7) Kovacevic L, Jurewicz M, Dabaja A, Thomas R, Diaz M, Madgy DN, et al. Enuretic children with obstructive sleep apnea syndrome: should they see otolaryngology first? J Pediatr Urol. 2013;9(2):145-50. doi: 10.1016/j.jpurol.2011.12.013.
- 8) Koff SA. Estimating bladder capacity in children. Urology. 1983;21(3):248. doi: 10.1016/0090-4295(83)90079-1.
- 9) Carroll JL, McColley SA, Marcus CL, Curtis S, Loughlin GM. Inability of clinical history to distinguish primary snoring from obstructive sleep apnea syndrome in children. Chest. 1995;108(3):610-8. doi: 10.1378/chest.108.3.610.
- 10) Ramakrishnan K. Evaluation and treatment of enuresis. Am Fam Physician. 2008;78(4):489-96.
- 11) Wojcik LJ, Kaplan GW. The wet child. Urol Clin North Am. 1998;25(4):735-44. doi: 10.1016/s0094-0143(05)70061-6.
- 12) Su MS, Li AM, So HK, Au CT, Ho C, Wing YK. Nocturnal enuresis in children: prevalence, correlates, and relationship with obstructive sleep apnea. J Pediatr. 2011;159(2):238-42. doi: 10.1016/j.jpeds.2011.01.036.
- 13) Barone JG, Hanson C, DaJusta DG, Gioia K, England SJ, Schneider D. Nocturnal enuresis and overweight are associated with obstructive sleep apnea. Pediatrics. 2009;124(1):e53-9. doi: 10.1542/peds.2008-2805.
- 14) Lehmann KJ, Nelson R, MacLellan D, Anderson P, Romao RLP. The role of adenotonsillectomy in the treatment of primary nocturnal enuresis in children: A systematic review. J Pediatr Urol. 2018;14(1):53.e1-8. doi: 10.1016/j.jpurol.2017.07.016.
- 15) Azevedo Soster L, Alves R, Fagundes SN, Koch VHK, Bruni O. Sleep disturbances associated with sleep enuresis: A questionnaire study. Eur J Paediatr Neurol. 2016;20(2):282-5. doi: 10.1016/j.ejpn.2015.11.014.
- 16) Tsuji S, Takewa R, Ohnuma C, Kimata T, Yamanouchi S, Kaneko K. Nocturnal enuresis and poor sleep quality. Pediatr Int. 2018;60(11):1020-3. doi: 10.1111/ped.13703.
- 17) Lam YY, Chan EY, Ng DK, Chan CH, Cheung JM, Leung SY, et al. The correlation among obesity, apnea-hypopnea index and tonsil size in children. Chest. 2006;130(6):1751-6. doi: 10.1378/chest.130.6.1751.
- 18) Weintraub Y, Singer S, Alexander D, Hacham S, Menuchin G, Lubetzky R, et al. Enuresis--an unattended comorbidity of childhood obesity. Int J Obes (Lond). 2013;37(1):75-8. doi: 10.1038/ijo.2012.108.
- 19) Erdem E, Lin A, Kogan BA, Feustel PJ. Association of elimination dysfunction and body mass index. J Pediatr Urol. 2006;2(4):364-7. doi: 10.1016/j.jpurol.2006.05.002.
- 20) Okur M, Ozen SF, Kocabay K, Cam K, Ozkan A, Uzun H. The effect of maximum voided volume on response to desmopressin therapy in children with enuresis. J Nippon Med Sch. 2012;79(4):255-8. doi: 10.1272/jnms.79.255.
- 21) Borg B, Kamperis K, Olsen LH, Rittig S. Evidence of reduced bladder capacity during nighttime in children with monosymptomatic nocturnal enuresis. J Pediatr Urol. 2018;14(2):160.e1-6. doi: 10.1016/j.jpurol.2017.09.021.
Abstract
Aim: It was aimed to investigate the relationship between the sleep disorders and monosymptomatic enuresis nocturna (MEN) and also to evaluate the possible etiological factors causing MEN.
Material and methods: Fifty patients having complaints of enuresis nocturna were evaluated prospectively between September 2012 and December 2013. All of the cases were evaluated and patients with secondary organic causes were excluded from the study. As a result of the anamnesis and examinations, 34 patients (68.0%) determined to have primary MEN underwent sleep test all night with full polysomnography method.
Results: Twenty nine (85.3%) of the patients were diagnosed with different degrees of obstructive sleep apnea syndrome (OSAS) and included in the study. Correlation of the apnea score values with the patients' age, frequency of bedwetting, body mass index (BMI) and bladder capacity were analyzed; and there was only a statistically significant positive correlation with BMI (r=0.384, p=0.047). The patients were divided into weight groups and compared in terms of apnea score, bed wetting frequency and bladder capacity; and the median apnea score of the obese group was found to be statistically significantly higher than the normal and overweight groups (p=0.019).
Conclusion: OSAS and obesity are present in a significant proportion of patients diagnosed with MEN, and these two diseases are effective factors in the development of MEN.
Project Number
2012.04.03.102
References
- 1) Vande Walle J, Rittig S, Bauer S, Eggert P, Marschall-Kehrel D, Tekgul S. Practical consensus guidelines for the management of enuresis. Eur J Pediatr. 2012;171(6):971-83. doi: 10.1007/s00431-012-1687-7.
- 2) Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-78. doi: 10.1002/nau.10052.
- 3) Weaver A, Dobson P. Nocturnal enuresis in children. J Fam Health Care. 2007;17(5):159-61.
- 4) Jain S, Bhatt GC. Advances in the management of primary monosymptomatic nocturnal enuresis in children. Paediatr Int Child Health. 2016;36(1):7-14. doi: 10.1179/2046905515Y.0000000023.
- 5) Van Herzeele C, Dhondt K, Roels SP, Raes A, Hoebeke P, Groen LA, et al. Desmopressin (melt) therapy in children with monosymptomatic nocturnal enuresis and nocturnal polyuria results in improved neuropsychological functioning and sleep. Pediatr Nephrol. 2016;31(9):1477-84. doi: 10.1007/s00467-016-3351-3.
- 6) Choudhary B, Patil R, Bhatt GC, Pakhare AP, Goyal A, P A, et al. Association of Sleep Disordered Breathing with Mono-Symptomatic Nocturnal Enuresis: A Study among School Children of Central India. PLoS One. 2016;11(5):e0155808. doi: 10.1371/journal.pone.0155808.
- 7) Kovacevic L, Jurewicz M, Dabaja A, Thomas R, Diaz M, Madgy DN, et al. Enuretic children with obstructive sleep apnea syndrome: should they see otolaryngology first? J Pediatr Urol. 2013;9(2):145-50. doi: 10.1016/j.jpurol.2011.12.013.
- 8) Koff SA. Estimating bladder capacity in children. Urology. 1983;21(3):248. doi: 10.1016/0090-4295(83)90079-1.
- 9) Carroll JL, McColley SA, Marcus CL, Curtis S, Loughlin GM. Inability of clinical history to distinguish primary snoring from obstructive sleep apnea syndrome in children. Chest. 1995;108(3):610-8. doi: 10.1378/chest.108.3.610.
- 10) Ramakrishnan K. Evaluation and treatment of enuresis. Am Fam Physician. 2008;78(4):489-96.
- 11) Wojcik LJ, Kaplan GW. The wet child. Urol Clin North Am. 1998;25(4):735-44. doi: 10.1016/s0094-0143(05)70061-6.
- 12) Su MS, Li AM, So HK, Au CT, Ho C, Wing YK. Nocturnal enuresis in children: prevalence, correlates, and relationship with obstructive sleep apnea. J Pediatr. 2011;159(2):238-42. doi: 10.1016/j.jpeds.2011.01.036.
- 13) Barone JG, Hanson C, DaJusta DG, Gioia K, England SJ, Schneider D. Nocturnal enuresis and overweight are associated with obstructive sleep apnea. Pediatrics. 2009;124(1):e53-9. doi: 10.1542/peds.2008-2805.
- 14) Lehmann KJ, Nelson R, MacLellan D, Anderson P, Romao RLP. The role of adenotonsillectomy in the treatment of primary nocturnal enuresis in children: A systematic review. J Pediatr Urol. 2018;14(1):53.e1-8. doi: 10.1016/j.jpurol.2017.07.016.
- 15) Azevedo Soster L, Alves R, Fagundes SN, Koch VHK, Bruni O. Sleep disturbances associated with sleep enuresis: A questionnaire study. Eur J Paediatr Neurol. 2016;20(2):282-5. doi: 10.1016/j.ejpn.2015.11.014.
- 16) Tsuji S, Takewa R, Ohnuma C, Kimata T, Yamanouchi S, Kaneko K. Nocturnal enuresis and poor sleep quality. Pediatr Int. 2018;60(11):1020-3. doi: 10.1111/ped.13703.
- 17) Lam YY, Chan EY, Ng DK, Chan CH, Cheung JM, Leung SY, et al. The correlation among obesity, apnea-hypopnea index and tonsil size in children. Chest. 2006;130(6):1751-6. doi: 10.1378/chest.130.6.1751.
- 18) Weintraub Y, Singer S, Alexander D, Hacham S, Menuchin G, Lubetzky R, et al. Enuresis--an unattended comorbidity of childhood obesity. Int J Obes (Lond). 2013;37(1):75-8. doi: 10.1038/ijo.2012.108.
- 19) Erdem E, Lin A, Kogan BA, Feustel PJ. Association of elimination dysfunction and body mass index. J Pediatr Urol. 2006;2(4):364-7. doi: 10.1016/j.jpurol.2006.05.002.
- 20) Okur M, Ozen SF, Kocabay K, Cam K, Ozkan A, Uzun H. The effect of maximum voided volume on response to desmopressin therapy in children with enuresis. J Nippon Med Sch. 2012;79(4):255-8. doi: 10.1272/jnms.79.255.
- 21) Borg B, Kamperis K, Olsen LH, Rittig S. Evidence of reduced bladder capacity during nighttime in children with monosymptomatic nocturnal enuresis. J Pediatr Urol. 2018;14(2):160.e1-6. doi: 10.1016/j.jpurol.2017.09.021.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Articles |
| Authors | |
| Project Number | 2012.04.03.102 |
| Publication Date | September 18, 2021 |
| Submission Date | September 10, 2020 |
| Published in Issue | Year 2021 Volume: 4 Issue: 1 |