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1.
Sleep Med Clin ; 19(1): 169-176, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38368063

RESUMO

This article reports on the epidemiology, prevalence, and physiopathology of sleep-related urinary dysfunction, a new syndromic category proposed by the recently revised ICSD-3-TR classification. Sleep enuresis, whether primary or secondary, monosymptomatic or plurisymptomatic, will be reviewed in terms of risk factors, comorbidity, and diagnostic and therapeutic indications. A definition of nocturia and its impact on patients' health, quality of life, and mortality will follow. Finally, the impact of urge incontinence on various medical and neurologic disorders will be discussed. Special emphasis will be placed on the possible association of this parasomnia with several sleep disorders and poor, fragmented sleep.


Assuntos
Noctúria , Enurese Noturna , Transtornos do Sono-Vigília , Humanos , Qualidade de Vida , Enurese Noturna/complicações , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/terapia , Sono
2.
Neurourol Urodyn ; 43(1): 114-125, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37916430

RESUMO

BACKGROUND: A higher incidence of lower urinary tract symptoms (LUTS) in people with schizophrenia compared to the general population is often suggested. However, it is not clear whether this is a genuine association, and whether it is a direct result of schizophrenia itself, or a side-effect of certain antipsychotics. METHODS: We undertook a narrative review evaluating how the published literature reports the relationship between LUTS and schizophrenia and its treatments. We searched Embase, Ovid Emcare, and Ovid MEDLINE(R) ALL to August 2022, limited to the English language. We selected the following search terms: schizophrenia, schizophrenic, LUTS, overactive bladder, urinary urgency, urinary incontinence, overactive bladder, enuresis, nocturnal enuresis, and voiding dysregulation. We identified seven domains for assessment in advance of commencing the review. These were the categorization, description, and treatment status of schizophrenia; evaluation of LUTS; categorization of LUTS confounders; recapturing of the disease states of both schizophrenia and LUTS after therapies; assessment of the association between LUTS and schizophrenia and/or antipsychotics. RESULTS: The association between LUTS and schizophrenia was poorly described. The evidence was low quality and focused predominantly on urinary incontinence as an antipsychotic side effect, neglecting other LUTS. The status of schizophrenia was often incompletely characterized, and no papers made use of a bladder diary or LUTS-specific questionnaires to assess symptoms. No papers collected information about LUTS in patients not on antipsychotics, nor did any thoroughly evaluate the influence of confounding variables. Despite the tendency of symptoms and severity of both conditions to fluctuate over time, no studies fully assessed the status of both schizophrenia and LUTS at baseline, therapy initiation, and follow-up. CONCLUSIONS: It is not possible to state whether there is an association between LUTS and schizophrenia or its treatments. This review highlights the need to improve research and clinical management of the urinary tract in schizophrenia, with meticulously designed longitudinal studies.


Assuntos
Sintomas do Trato Urinário Inferior , Enurese Noturna , Esquizofrenia , Bexiga Urinária Hiperativa , Incontinência Urinária , Humanos , Bexiga Urinária Hiperativa/tratamento farmacológico , Bexiga Urinária Hiperativa/epidemiologia , Esquizofrenia/complicações , Esquizofrenia/tratamento farmacológico , Esquizofrenia/epidemiologia , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/terapia , Incontinência Urinária/epidemiologia , Micção/fisiologia , Enurese Noturna/complicações
3.
Urology ; 182: 218-224, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37696309

RESUMO

OBJECTIVE: To prospectively investigate the nocturnal bladder function and sleep in children with refractory primary monosymptomatic nocturnal enuresis (RPMNE). MATERIALS AND METHODS: Fifty-three children diagnosed with RPMNE and 30 controls who had upper urinary tract abnormality but without any voiding problems were included in the study. RPMNE patients underwent a standardized investigation protocol, including the Pittsburgh Sleep Quality Index (PSQI) questionnaire, a 7-day bladder diary, and the simultaneous ambulatory urodynamic monitoring and polysomnography (PSG); controls were evaluated using the PSQI questionnaire and PSG. RESULTS: The children with RPMNE were subdivided into the nocturnal detrusor overactivity (NDO) case group and the non-NDO case group. The children in the NDO case group had a higher percentage of total sleep time in light sleep and a lower percentage in the N3 sleep stage than those in the non-NDO case group and control group (P <.05). The cortical arousal index and PSQI scores of both RPMNE subgroups were higher compared to the control group (P <.05). The incidences of reduced nocturnal bladder capacity (NBC) in the NDO case group were higher than in the non-NDO case group (P <.05). The frequency of involuntary detrusor contractions during sleep was positively correlated with cortical arousal index in the NDO case group (r = 0.811, P <.0001). CONCLUSION: In addition to the reduced NBC, the RPMNE is related to abnormal NDO, increased light sleep period, and cortical arousal dysfunction. Moreover, there is a certain correlation between the abnormal degrees of NDO and cortical arousal dysfunction.


Assuntos
Enurese Noturna , Doenças da Bexiga Urinária , Criança , Humanos , Enurese Noturna/complicações , Bexiga Urinária , Estudos Prospectivos , Sono
4.
BMC Pediatr ; 23(1): 141, 2023 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-36997891

RESUMO

BACKGROUND: Asthma is the most common chronic disease in children. Asthma can lead to sleep disorders and psychiatric issues, which are often accompanied by urinary incontinence in children. Furthermore, several studies have shown a relationship between allergic diseases and urinary incontinence. This study aims to examine the association between asthma and non-neurogenic urinary incontinence. MATERIALS AND METHODS: This case-control study included 314 children over three years old referred to Amir Kabir Hospital; 157 with asthma and 157 without asthma. After explaining each urinary disorder in accordace with the International Children's Continence Society's definitions, parents and children were asked about their presence. The disorders included monosymptomatic nocturnal enuresis(MNE), nonmonosymptomatic nocturnal enuresis (NMNE), vaginal reflux (VR), pollakiuria, infrequent voiding, giggle incontinence (GI), and overactive bladder (OAB). The analysis was performed using Stata 16. RESULTS: The average age of the children was 8.19 ± 3.15 years. Patients with asthma (p = 0.0001) and GI (p = 0.027) had a considerably lower average age than patients without these disorders. Asthma and urinary incontinence, including NMNE, Infrequent voiding, and OAB, were significantly correlated (p = 0.017, 0.013, and 0.0001, respectively). Moreover, the association between MNE and asthma was significant in males (p = 0.047). CONCLUSION: Due to the relationship between asthma and urinary incontinence, children with asthma must be evaluated for the presence of urinary disorders and, if present, receive the proper treatment in order to improve their quality of life.


Assuntos
Asma , Enurese Noturna , Bexiga Urinária Hiperativa , Incontinência Urinária , Masculino , Feminino , Humanos , Criança , Pré-Escolar , Enurese Noturna/complicações , Enurese Noturna/epidemiologia , Estudos de Casos e Controles , Qualidade de Vida , Incontinência Urinária/complicações , Incontinência Urinária/epidemiologia , Asma/complicações
6.
Neurourol Urodyn ; 41(8): 1800-1808, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35979705

RESUMO

OBJECTIVE: The aim was to examine associations of specific anxiety disorders, depressive symptoms, and incontinence in a representative, population-based sample of preschool children. METHODS: All preschool children of a defined geographical area examined before school-entry were included. Parents completed a questionnaire including the Preschool Feelings Checklist (PFC), eight questions referring to nocturnal enuresis (NE), daytime urinary incontinence (DUI), fecal incontinence (FI) and constipation, and 30 items regarding Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) diagnostic criteria of separation anxiety disorder (SAD), social phobia (SOC), specific phobia (PHOB), and generalized anxiety disorder (GAD). Data of 1206 children (mean age = 5.7 years; 53.5% boys) are presented. RESULTS: 34.6% of incontinent children had an anxiety disorder based on DSM-5 criteria and 13.3% had clinically relevant depressive symptoms (measured by the PFC). Rates of incontinence overall were 14.1% (11.9% NE, 3.1% DUI, and 1.8% FI) and 6.3% for constipation. Rates of SOC and PHOB were increased in NE (20.8% and 25.4%), DUI (39.3% and 34.5%) and FI (35.3% and 50.0%) compared to continent children (13.5% and 17.2%). Children with constipation had higher rates of SOC, PHOB, and GAD than those without. Compared to continent children (9.7%), depressive symptoms were more frequent in children with NE (26.8%), DUI (50.0%), and FI (61.9%). CONCLUSION: Anxiety disorders and depressive symptoms are common in children with incontinence. The most specific DSM-5 disorders associated with incontinence are SOC and PHOB, which can be incapacitating and may require treatment. Due to the high rates of anxiety disorders, it is important to screen all children with incontinence, for example, with specific questionnaires.


Assuntos
Enurese Diurna , Incontinência Fecal , Enurese Noturna , Masculino , Pré-Escolar , Humanos , Feminino , Depressão/epidemiologia , Enurese Diurna/complicações , Enurese Noturna/complicações , Incontinência Fecal/complicações , Inquéritos e Questionários , Constipação Intestinal/complicações , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/complicações
7.
Tokai J Exp Clin Med ; 47(2): 72-74, 2022 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-35801551

RESUMO

Nocturnal enuresis (NE) is a syndrome associated with abnormal nocturnal urine production, urination mechanism, and sleep arousal. NE is strongly associated with attention-deficit/hyperactivity disorder (ADHD), and it has been reported that NE occurs in approximately 30% of children with ADHD. There have been several reports on the efficacy of atomoxetine as treatment for NE with ADHD, while the efficacy of guanfacine is still limited. We report our experience of treating an 10-year-old girl with NE with ADHD with a single dose of guanfacine. The patient first visited our hospital because of difficulty concentrating, restlessness at home and school, and nocturnal incontinence. She was diagnosed with NE with ADHD based on a review of her personal history from her mother. Her NE symptoms improved with guanfacine monotherapy (1 mg/day. The patient weighed 28 kg).


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Enurese Noturna , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Criança , Feminino , Guanfacina/uso terapêutico , Humanos , Enurese Noturna/complicações , Enurese Noturna/etiologia
8.
Neurourol Urodyn ; 41(6): 1451-1457, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35662237

RESUMO

INTRODUCTION: Adult nocturnal enuresis (NE) is an understudied and bothersome condition. Our objective was to conduct a conjoint analysis experiment to better understand the relative importance of NE consequences in older women. METHODS: We developed a conjoint analysis survey that included four attributes related to NE (awakening at night, feeling rested in the morning, restricting fluid before bed, and wet perineal skin). We performed a prospective cross-sectional online study of women >62 years of age with NE using Sawtooth Software. Patients completed baseline questions, the International Consultation on Incontinence Questionnaire-nocturia Quality of Life (ICIQ-NqoL), and the conjoint analysis experiment. Hierarchical Bayes random effects regression analysis was used to determine the relative importance of the four attributes. RESULTS: A total of 200 women with a mean age of 71 years completed the study. The most common management of NE was diapers/pads (132/200). Approximately half of the participants experienced NE several times a week or nightly (101/200). The most important attribute was the frequency of being awakened at night (34, standard deviation [SD]: 16) and the frequency of feeling rested in the morning (32, SD: 15). Limiting drinking before bed (18, SD: 12) and wet groin skin (16, SD: 10) had significantly lower importance scores (p < 0.05). Age, sleeping with a partner in bed, body mass index, NE severity score, and the ICIQ-NqOL score were not significantly associated with any of the importance scores. CONCLUSIONS: Older women with NE place significantly more importance on the frequency of awakening at night, and feeling rested in the morning and lesser importance on associated lifestyle or physical manifestations of NE.


Assuntos
Enurese Noturna , Adulto , Idoso , Teorema de Bayes , Estudos Transversais , Feminino , Humanos , Enurese Noturna/complicações , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários
9.
Bull Menninger Clin ; 86(1): 67-89, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35258343

RESUMO

This 8-week longitudinal study examined predictors of response to simple behavioral intervention in primary enuresis nocturna (PEN). A total of 154 children, aged 8-18 years, diagnosed with PEN were evaluated. The results indicated that lack of constipation, milder enuresis severity, and higher bladder capacity are the primary predictors of good treatment response, and lower family dysfunction is the most robust familial predictor. Lack of constipation is the main predictor with unique variance in multiple regression. Specialists should be aware of conditions that hinder the success of simple behavioral intervention before implementing costly treatments. In treatment-refractory cases, it is important to examine each child for constipation. Family-centered approaches can be helpful if used in parallel with behavioral treatments.


Assuntos
Enurese Noturna , Adolescente , Terapia Comportamental , Criança , Humanos , Estudos Longitudinais , Enurese Noturna/complicações , Enurese Noturna/diagnóstico , Enurese Noturna/terapia
10.
J Pediatr Hematol Oncol ; 44(7): 358-362, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-35180759

RESUMO

Nocturnal enuresis is a common symptom in children with sickle cell disease (SCD). Risk factors for development of enuresis are currently unknown. An early manifestation of SCD-associated kidney damage is glomerular hyperfiltration. We test the hypothesis that in a pediatric SCD cohort, individuals with hyperfiltration are more likely to have nocturnal enuresis when compared to children without hyperfiltration. To assess the relationship between nocturnal enuresis and hyperfiltration, we retrospectively evaluated children with SCD enrolled in the Evaluation of Nocturnal Enuresis and Barriers to Treatment among Pediatric Patients with SCD study and prospectively identified children who reported nocturnal enuresis and were enrolled in the longitudinal cohort study Sickle Cell Clinical Research and Intervention Program. Nocturnal enuresis occurred in 46.5% of Pediatric Patients with Sickle Cell Disease participants and was more frequent in participants with HbSS/HbSß 0 thalassemia and in male participants. We did not identify an association between hyperfiltration from 3 to 5 years of age with the later development of enuresis. Severe SCD genotypes and male sex were associated with nocturnal enuresis after age 5 years. We could not identify additional renal or hematologic predictors associated with the diagnosis of nocturnal enuresis. Future studies should incorporate nonrenal risk factors into studies that predict development of enuresis.


Assuntos
Anemia Falciforme , Nefropatias , Enurese Noturna , Anemia Falciforme/complicações , Criança , Pré-Escolar , Feminino , Humanos , Nefropatias/complicações , Estudos Longitudinais , Masculino , Enurese Noturna/complicações , Enurese Noturna/etiologia , Estudos Retrospectivos
11.
Urology ; 164: 106-111, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35038490

RESUMO

OBJECTIVE: To examine whether a history of nocturnal enuresis affects nighttime urinary frequency and to evaluate nocturia etiologies in adults. MATERIALS AND METHODS: A total of 143 participants with at least one episode of nocturia per night were included in this study. The self-reported questionnaire collected data on demographic characteristics, medical history, history of nocturnal enuresis in elementary school, lower urinary tract symptoms, and frequency-volume charts. RESULTS: A history of nocturnal enuresis was observed in 52.4% of participants. However, night-time urinary frequency was significantly lower in participants with a history of nocturnal enuresis in elementary school than in those without such history. On multivariate analysis, a history of nocturnal enuresis was also negatively associated with nighttime urinary frequency (P <.01). There was a collinearity effect between age and nighttime urinary frequency. A history of nocturnal enuresis did not affect the presence of nocturnal polyuria or overactive bladder in participants. However, sleep disturbances were fewer in participants with a history of nocturnal enuresis (odds ratio 0.404). CONCLUSION: A history of nocturnal enuresis might be negatively associated with nighttime urinary frequency due to fewer sleep disturbances. Further, progression of nocturia may depend on conditions, such as age and acquired diseases.


Assuntos
Sintomas do Trato Urinário Inferior , Noctúria , Enurese Noturna , Transtornos do Sono-Vigília , Bexiga Urinária Hiperativa , Adulto , Humanos , Sintomas do Trato Urinário Inferior/complicações , Noctúria/complicações , Noctúria/epidemiologia , Enurese Noturna/complicações , Enurese Noturna/epidemiologia , Inquéritos e Questionários , Bexiga Urinária Hiperativa/complicações
12.
Neurourol Urodyn ; 41(2): 633-642, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34989456

RESUMO

AIMS: Nocturnal enuresis (NE), daytime urinary incontinence (DUI), fecal incontinence (FI), as well as sleep and behavioral problems are common in young children. The aim of this study was to analyze the association of sleep and psychological parameters for all types of incontinence in a representative sample of young children. METHODS: Six hundred thirty eight (of 1161) children with a mean age of 5.9 years (50.9% boys) were assessed during their mandatory school entry examination. The participation rate was 55%. Instruments included the Strengths and Difficulties Questionnaire, the Children's Sleep Habits Questionnaire and other clinical questions. Incontinence was diagnosed according to ICCS standards. Constipation was assessed by two questions. RESULTS: 17.1% of children had at least one type of incontinence, 14.8% had NE, 5.0% DUI, 2.1% FI, and 4.8% were constipated. 6.7% of children had clinically relevant psychological problems. 22.7% of children had sleep problems regularly (5-7 times/week). A wide variety of sleep problems were reported. Children with incontinence were not affected by a higher rate of sleep problems. Children with NE had fewer night wakings and those with constipation fewer parasomnias. Sleep and psychological problems were significantly associated, especially in children with DUI and FI. CONCLUSIONS: Sleep and behavioral problems are common in young children. Psychological problems have a clear impact on sleep. Young children with incontinence do not have more sleep problems than continent children. Therefore, both sleep and psychological problems should be addressed in young children with incontinence.


Assuntos
Enurese Diurna , Incontinência Fecal , Enurese Noturna , Transtornos do Sono-Vigília , Criança , Pré-Escolar , Enurese Diurna/complicações , Incontinência Fecal/psicologia , Feminino , Humanos , Masculino , Enurese Noturna/complicações , Sono , Transtornos do Sono-Vigília/epidemiologia , Inquéritos e Questionários
13.
Neurourol Urodyn ; 40(1): 326-333, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33118643

RESUMO

AIM: To evaluate the relationship between nocturia and medical history of nocturnal enuresis: two conditions where diurnal urination rhythm is disturbed. METHODS: The Nagahama study is a longitudinal population-based health survey involving people aged 30-75 years in Nagahama city, Japan. Our analysis included 5,402 participants who completed enuresis and International Prostate Symptom Score questionnaires. Associations between nocturnal enuresis and nocturia were evaluated cross-sectionally and longitudinally with three models: (1) univariate analysis; (2) adjusted for basic characteristics (e.g., age, sex, body mass index, activity, alcohol, and smoking); and (3) adjusted for basic and clinical variables (e.g., hyperglycemia, hyperlipidemia, hypertension, renal insufficiency, insomnia, obstructive sleep apnea, and mental health). RESULTS: In total, 1,613 participants (29.9%) had a medical history of enuresis. The mean night-time frequency was 0.73 at baseline and 0.85 at the 5-year follow-up. The cross-sectional analysis showed participants with a medical history of enuresis had night-time frequency more often than those without this history (0.84 vs. 0.68, p < .0001). Significant differences were observed in Models 2 (p < .0001) and 3 (p < .0001). The longitudinal analysis showed nocturia progression was significantly related to a history of enuresis, with odds ratios of 1.32 (p < .0001) in Model 1, 1.21 (p < .01) in Model 2, and 1.22 (p < .01) in Model 3. CONCLUSIONS: Medical history of enuresis during school age was significantly related to nocturia in adulthood in the cross-sectional analysis, and to progression to nocturia in the longitudinal analysis. These two conditions may possess a common causative association.


Assuntos
Noctúria/etiologia , Enurese Noturna/complicações , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Noctúria/fisiopatologia , Fatores de Risco
14.
Investig Clin Urol ; 61(5): 521-527, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32869565

RESUMO

PURPOSE: Poor awakening in patients with enuresis has been assumed to be an adaptation to the chronic influence of arousal stimuli like lower urinary tract dysfunction (LUTD). This study aimed to examine the effect of controlling LUTD on improvement of awakening and cure of enuresis. MATERIALS AND METHODS: Data for 119 enuretic patients with overactive bladder were retrospectively analyzed. The patients received urotherapy, laxatives, and anticholinergic agents. LUTD symptoms and enuresis were regularly monitored every 3 months. History of waking up because of bedwetting (ability to awaken, AA) was used as a surrogate marker of arousal and was graded at baseline and every 3 months of treatment. Changing distribution of each grade of AA was associated with other LUTD symptoms. Multivariate analysis was applied to understand whether the lack of improvement in AA might harbor any prognostic implications regarding cure of enuresis. RESULTS: Decreasing number of LUTD with treatment corresponded to increasing number of better AA. Enuresis was resolved completely in 88 patients in a median time of 7 months. Failure to show even single episode of awakening before bedwetting within 6 months of treatment and persistent daytime incontinence were identified as risk factors for treatment resistance until 18 months of treatment. CONCLUSIONS: Controlling LUTD symptoms in the management of nonmonosymptomatic enuresis was crucial for not only the treatment of enuresis but also for allowing the patients to obtain better arousal. AA tended to improve subsequent to bladder control and may contribute to the cure of enuresis.


Assuntos
Sintomas do Trato Urinário Inferior/terapia , Enurese Noturna/terapia , Criança , Pré-Escolar , Humanos , Sintomas do Trato Urinário Inferior/complicações , Masculino , Enurese Noturna/complicações , Estudos Retrospectivos , Sono , Resultado do Tratamento
15.
Ital J Pediatr ; 46(1): 128, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32917238

RESUMO

AIM: To describe the epidemiological aspects of nocturnal enuresis (NE). In this study we identify the prevalence and the familial conditions in a large, representative sample of children with monosymptomatic NE (MNE) and nonmonosyptomatic NE (NMNE). MATERIAL AND METHODS: In this descriptive-analytic study the Italian Society of Pediatrics (SIP) promoted a prevalence study of NE using a questionnaire involved 320 primary care Pediatricians from Northern, Central and Southern Italy, from January 2019 to July 2019, with a total of 130,000 children analyzed by questionnaire related to epidemiology and type of NE, familiarity, quality of sleep, eating and drinking habits, pharmacological and psychological/behavioural interventions and family involvement. RESULTS: 270/320 (84.4%) Paediatrician replied to our questionnaire. We enrolled a total of 9307/130,000 (7.2%) children with NE, aged between 5 and 14 years: 2141 diagnosed with MNE and 7176 qualified as NMNE. Poor quality of sleep were reported in 7064 patients; 90% of children did not consider a dietary and drinking recommendation. Pediatrician reported a total of 54.1% of parents who declared to have a negative reaction to their children because of the bedwetting. A percentage of 71.4% of parents declared to use or to have used alternative therapies and not to prefer, at first, a pharmacological intervention. CONCLUSION: The choice of treatment should include psychological/behavioural interventions in all cases to improve the therapeutic outcome. All primary care Pediatricians should be aware of the all aspects of NE to choose the best way to treat every patient.


Assuntos
Enurese Noturna/diagnóstico , Enurese Noturna/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Itália , Masculino , Enurese Noturna/complicações , Prevalência , Estudos Retrospectivos , Fatores de Risco , Inquéritos e Questionários , Avaliação de Sintomas
16.
Medicine (Baltimore) ; 99(28): e20997, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664103

RESUMO

INTRODUCTION: Wilson disease (WD) is an autosomal-recessive disorder of copper metabolism, which exhibits various symptoms due to the combination of environmental and genetic factors. Here, we report a WD patient who displayed distinctive symptom of nocturnal enuresis. PATIENT CONCERNS: The patient was a 31-year old woman, who recently developed nocturnal enuresis, combined with hand tremors, trouble speaking, and panic disorder at night. DIAGNOSIS: The patient had been diagnosed with WD by Kayser-Fleischer rings, abnormal copper metabolism, neuropsychiatric symptoms, and magnetic resonance imaging when she was 17. The diagnosis was further confirmed by genetic analysis, which revealed a compound heterozygous mutations in ATP7B gene (c.2195T>C and c.3044T>C). The patient exhibited nocturnal enuresis, but the ambulatory electroencephalogram, routine urinalysis, residual urine detection, color doppler ultrasound of kidney, ureter, and bladder all displayed no abnormality. INTERVENTIONS: The patient was treated with sodium dimercaptosulphonate, supplemented with Glutathione and Encephalin-inosine. OUTCOMES: The urinary copper excretion level decreased gradually, and the nocturnal enuresis was alleviated along with the neuropsychiatric symptoms by copper chelation therapy. CONCLUSION: In this study, we proved that variants c.2195T>C and c.3044T>C is involved in pathogenesis of WD, and revealed that nocturnal enuresis may be a symptom of WD.


Assuntos
ATPases Transportadoras de Cobre/genética , Degeneração Hepatolenticular/genética , Mutação , Adulto , Feminino , Degeneração Hepatolenticular/complicações , Heterozigoto , Humanos , Enurese Noturna/complicações
17.
BJU Int ; 126(4): 472-480, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32475016

RESUMO

OBJECTIVES: To characterise the clinical features and to discover predictive factors of adult males with nocturnal enuresis (NE). PATIENTS AND METHODS: A total of 43 eligible adult male patients (mean age was 57.8 years) were recruited prospectively over a 2-year period. After documentation of medical history, lower urinary tract symptoms (LUTS) were assessed using the International Consultation on Incontinence Modular Questionnaire-male LUTS (ICIQ-MLUTS), and a 3-day ICIQ-bladder diary (ICIQ-BD). Video-urodynamic studies (VUDS) were conducted conforming to the International Continence Society standards. Univariate and multivariate linear regressions were performed to determine potential predictive factors. RESULTS: Patients with NE had a variety of LUTS and had a high incidence of obesity and comorbidities. On the ICIQ-BD, NE was associated with nocturnal polyuria (NP), reduced nocturnal bladder capacity (NBC), or a combination of both. Subgroup analysis indicated that patients with more frequent NE had: higher body mass index (BMI); more comorbidities; reduced daytime urinary frequency and urgency quality of life (QoL) sub-scores; and increased stress urinary incontinence (SUI) and nocturnal bedwetting sub-scores. Patients with reduced NBC only, had fewer NE episodes, while patients with NP, or with both NP and reduced NBC were more likely have frequent NE. Multivariate analysis confirmed that: BMI; neurogenic causes; sub-scores of SUI QoL and bedwetting domain; the presence of reduced NBC, and both NP and reduced NBC; and bladder outlet obstruction, were all independent predictive factors for the severity of NE. CONCLUSIONS: NE n the adult male should be systemically assessed and treated, as obesity, neurogenic disorders, excessive urine production, bladder storage and emptying dysfunctions are risk factors. Bladder diaries and VUDS provide valuable information on potential pathophysiological causes, which could assist clinical evaluation and selection of focussed treatment.


Assuntos
Enurese Noturna/complicações , Enurese Noturna/epidemiologia , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , Comorbidade , Humanos , Masculino , Pessoa de Meia-Idade , Enurese Noturna/fisiopatologia , Qualidade de Vida , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários , Urodinâmica
18.
Investig Clin Urol ; 61(2): 207-215, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32158972

RESUMO

Purpose: Brain dysfunction related to areas regarding attention and arousal may occur not only in patients with attention-deficit/hyperactivity disorder (ADHD) but also in patients with enuresis and daytime symptoms. This study aimed to investigate changes in computerized comprehensive attention tests (CATs), a psychometric test for ADHD when patients with nonmonosymptomatic enuresis (NME) were treated with anticholinergic agents. Materials and Methods: Thirty patients with NME featuring overactive bladder were prospectively enrolled. They were treated with 5 mg of solifenacin to control daytime symptoms. Using CATs, patients were evaluated during 12 weeks of treatment. Four subtests of attention (visual and auditory selective attention, sustained attention, and flanker tests) were measured. For each subtest, four domains (omission error, commission error, response time [RT], and standard deviation of RT) were assessed. Results: Only one domain of the flanker test was in the deficient range at baseline. The presence of urge incontinence affected follow-up results on the sustained attention tests. Treatment with anticholinergic agents did not significantly affect attention variables but changes in several variables were correlated with bladder symptoms and enuresis. Conclusions: Minimal baseline defects in attention function were seen in patients with NME. Follow-up results for some attention variables were affected by daytime symptoms and enuresis. These results suggest that altered brain function in enuretic patients influences improvement in both attention and bladder function.


Assuntos
Atenção , Antagonistas Colinérgicos/uso terapêutico , Enurese Noturna/tratamento farmacológico , Enurese Noturna/psicologia , Succinato de Solifenacina/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Enurese Noturna/complicações , Estudos Prospectivos
19.
BMC Pediatr ; 20(1): 35, 2020 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992241

RESUMO

BACKGROUND: The relationship between constipation and childhood nocturnal enuresis (NE) has been previously reported; however, this relationship remains controversial. The present study aimed to evaluate the association between constipation and childhood NE. METHODS: Data from the Longitudinal Health Insurance Database 2000 (LHID 2000) of Taiwan National Health Insurance Research Database from 2000 to 2013 were collected. A total of 2286 children were enrolled in this study: a case group of 1143 children aged 5-18 years who were diagnosed with NE (NE group) and an age- and sex-matched control group of 1143 children without NE. Conditional logistic regression and odds ratio (OR) for NE were used to examine the association between constipation and childhood NE. RESULTS: The prevalence of NE in the case group (NE group, aged 5-18 years) was 1.03% from 2000 to 2013. The NE group had a higher percentage of constipation in 1 year before the diagnosis of NE. After stratification for sex, both boys and girls with constipation had higher OR for NE. With stratification for age, children aged 5-12 and 7-12 years had a higher OR for NE. CONCLUSIONS: Constipation is associated with childhood NE in Taiwan, particularly in children aged 5-7 and 7-12 years.


Assuntos
Constipação Intestinal/complicações , Enurese Noturna/complicações , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Enurese Noturna/epidemiologia , Razão de Chances , Prevalência , Taiwan/epidemiologia
20.
Acta pediátr. hondu ; 10(2): 1057-1062, oct. 2019-mar. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1118519

RESUMO

Antecedentes: La Enuresis nocturna, es una enfermedad prevalente aproximadamente en 18% de los pacientes pediátricos, se ha asociado a diferentes patologías, como el transtorno por déficit de atención e hiperactividad (TDAH), la constipación y trastornos del sueño, el diagnóstico oportuno es importante. Objetivo: Describir el perfil clínico, epidemiológico y sociocultural de los niños que presentan enuresis nocturna, evaluados en centros educativos Fidelina Cerros en Barrio Chamelecón y Miguel Paz Barahona en Cofradía Departamento de Cortés. Pacientes y métodos: Estudio no experimental, Cuantitativo, Descriptivo, de agosto 2018 a mayo 2019, con una muestra de 200 niños, Resultados: La prevalencia encontrada fue de 16.7% y la edad promedio de 7.72 años, 61% hombres, 100% residentes del casco urbano. El 80% presento buena adaptación escolar, 33% no tenían fácil acceso a servicios de salud y solo el 47.5% llevaba controles periódicos de salud, 67% presento enuresis diurna y 45% pesadillas. Conclusiones: Los pacientes con enuresis nocturna de escuelas metropolitanas de san pedro sula se caracterizan así: edad 7 u 8 años, sexo masculino, viven en casas con servicios básicos sin patio, pero con adecuado material de construcción, que comparten habitación e inclusive viven en hacinamiento, con pocos controles de salud periódicos y con acceso a centros de atención de salud del área metropolitana...(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Enurese Noturna/complicações , Transtornos do Sono-Vigília/complicações , Saneamento de Escolas
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