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Time Course of Treatment for Primary Enuresis With Overactive Bladder
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논문 기본 정보

Type
Academic journal
Author
Journal
대한배뇨장애요실금학회 International Neurourology Journal International Neurourology Journal 제22권 제2호 KCI Accredited Journals
Published
2018.1
Pages
107 - 113 (7page)

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Time Course of Treatment for Primary Enuresis With Overactive Bladder
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Abstract· Keywords

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Purpose: To characterize the course of treatment for nonmonosymptomatic enuresis with overactive bladder (OAB) in a real clinical setting. Methods: Data from 111 OAB patients with moderate to severe enuresis were analyzed. The baseline analysis included a questionnaire, voiding diary, uroflowmetry with postvoid residual urine measurement, and plain abdominal radiography of the kidneys, ureters, and bladder (KUB). Following standard urotherapy for 1 month, anticholinergic medication was administered with or without laxatives. Desmopressin was added if there was a partial response to OAB. Patients were followed every 3 months to evaluate the status of OAB and enuresis. Multivariate analysis was performed to identify predictors associated with the lack of complete response (CR) in enuresis at 12 months. Results: Following 12 months of treatment, 64% and 88% of patients experienced at least partial response in enuresis and OAB, respectively. Urgency improved more quickly than enuresis, supporting the need to address daytime symptoms before enuresis. Seventy-nine patients (71%) had fecal impaction on KUB and/or subjective constipation. The combination of anticholinergics with either laxatives or desmopressin fared better than anticholinergics alone. Daytime incontinence and anticholinergics- only treatment were associated with a lack of CR during 12 months of treatment. Conclusions: The data confirmed the validity of addressing OAB before treating enuresis. The results of this study also highlight the need to address fecal impaction. Patients should be counseled about the need for a prolonged course of treatment before starting treatment. Anticholinergics should be accompanied with either desmopressin or laxatives for better control of enuresis.

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References (20)

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Neveus T / 2010 / Evaluation of and treatment for monosymptomatic enuresis: a standardization document from the International Children's Continence Society / J Urol 183:441~447 Crossref Franco I / 2013 / Evaluation and treatment of nonmonosymptomatic nocturnal enuresis: a standardization document from the International Children's Continence Society / J Pediatr Urol 9:234~243 Crossref Vande Walle J / 2012 / Practical consensus guidelines for the management of enuresis / Eur J Pediatr 171:971~983 Crossref Marks A / 2013 / Definition of reliable, objective criteria by abdominal radiography to identify occult constipation in children with lower urinary tract symptoms / J Urol 189:1519~1523 Crossref McGrath KH / 2008 / The frequency of constipation in children with nocturnal enuresis: a comparison with parental reporting / J Paediatr Child Health 44:19~27 google schola

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