Coexistence of Upper Airway Obstruction and Primary and Secondary Enuresis Nocturna in Children and the Effect of Surgical Treatment for the Resolution of Enuresis Nocturna
Objective. The aim of this study is to investigate the coexistence of upper airway obstruction (UAO) and primary enuresis nocturna (PEN) and secondary enuresis nocturna (SEN) in children. Besides, the efficacy of surgery on resolution of enuresis nocturna is evaluated. Materials and Methods. The children with PEN and SEN were included in the first group and investigated for UAO in the Department of Otorhinolaryngology. During the same period, children who had been planned for an operation to treat UAO over 5 years old were included in the second group and were evaluated in the Department of Urology for PEN and SEN before the operation. Results. A hundred patients completed the study (50 patients in Group 1, 50 patients in Group 2). According to the otolaryngologic examination, 20 of 25 PEN patients and 9 of 25 SEN patients also had UAO. The difference was statistically different ( ). The second group consisted of fifty patients on the surgery list for upper airway obstructive pathologies. Coexistence of PEN and SEN is found in 12 and 3 of children, respectively. These ratios were statistically significant ( ). The improvement rate of PEN and SEN after operation in the second group was 83.3% and 33.3%, respectively. The difference was statistically significant ( ). Conclusion. There is a strong relationship between PEN and UAO, but it cannot be declared for SEN patients. UAO should be kept in mind as a possible etiologic factor for PEN. 1. Introduction Upper airway obstruction (UAO) is estimated to be seen at 27% of paediatric population [1]. Nasal and/or oropharyngeal pathologies may be the reason of UAO. The most common cause is adenotonsillar hypertrophy [2]. Enuresis nocturna (EN) also called as intermittent nocturnal incontinence means the involuntary and recurrent wetting episodes during sleep. EN has two types: primary type, in which the child has never been dry at night, and the secondary type, in which a child has been dry for 6 months or more and then begins to wet the bed [3]. EN is reported in 8–47% of children with UAO and the improvement rate of enuresis after surgery in these patients is up to 76% [4]. Although there are several studies investigating the relationship between EN and UAO, there is still a lack of detailed prospective studies. Moreover, most of the studies did not make a distinction between primary and secondary types of enuresis. The aim of this study is to investigate the coexistence of UAO and PEN and SEN in children. Besides, the efficacy of surgery on resolution of enuresis nocturna is evaluated. 2. Materials and Methods
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