Enuresis and Hyperfiltration in Children With Sickle Cell Disease.

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.

Medical history of nocturnal enuresis during school age is an independent risk factor for nocturia in adults: The Nagahama study.

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.

Wilson disease patient with rare heterozygous mutations in ATP7B accompanied by distinctive nocturnal enuresis: A case report.

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.

Perfil clínico-epidemiológico, pacientes pediátricos con enuresis nocturna. Centros escolares, San Pedro Sula / Clinical-epidemiological profile, pediatric patients with nocturnal enuresis. schools, San Pedro Sula

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)

Is nocturnal enuresis a predisposing factor for the overactive bladder?

Background/aim: This study aimed to perform a limited observational study to ascertain whether there is statistical support that nocturnal enuresis (NE) is a predisposing factor in the development of overactive bladder (OAB). Materials and methods: The authors recruited patients diagnosed with OAB over a period of twelve months, and those who declared a history of NE were asked additional questions regarding the features of their NE. Results: A total of 285 patients were diagnosed with overactive bladder, and 98 (34.38%) of them had previously displayed NE symptoms that had diminished before reaching the median age of 9.83. Separation of patients by sex revealed a male majority (58.16%). Additionally, most patients had urban origins (75.51%). The median time span from remission of NE to diagnosis of OAB was 24.79 years, and the median age at which patients began to suffer was 31.80 years. Behavioral factors (smoking, alcohol consumption) and psychological and infectious factors (past history of urinary tract infection) were identified at varying degrees. Conclusion: The presence of NE in a third of the patients who developed over time OAB and the earlier onset of OAB for these patients suggests a causal physiopathological relationship between NE and OAB. The preponderance of urban patients confirms the existence of acquired urban triggering factors of OAB (nutritious, social, or professional).

Mental disorders in children and adolescents with lower urinary tract dysfunction / Transtornos mentais em crianças e adolescentes com disfunção do trato urinário inferior

Abstract Lower urinary tract dysfunction (LUTD) affects about 2-25% of the pediatric population and is associated with the presence of emotional and behavioral disorders. The purpose of this literature review was to identify studies focusing on mental disorders in children and adolescents with LUTD. The prevalence of these disorders is high - ranging from about 20 to 40% - in children with symptoms of LUTD and comorbidities. The presence of emotional and behavioral symptoms impact in the treatment of the dysfunction, self-esteem of patients and caregivers. Despite the association between mental/behavioral disorders and LUTD be well documented in the literature, the investigation of psychiatric symptoms in clinical practice is still not common and should be stimulated.

Resumo A disfunção do trato urinário inferior (DTUI) afeta cerca de 2 a 25% da população pediátrica e se associa à presença de transtornos emocionais e de comportamento. O objetivo dessa revisão bibliográfica foi selecionar estudos que enfoquem os transtornos mentais em crianças e adolescentes com DTUI. A prevalência destes transtornos é elevada - variando de cerca de 20 a 40% nas crianças com sintomas da DTUI e comorbidades. A presença de sintomas emocionais e comportamentais impacta no tratamento da disfunção, na autoestima dos pacientes e também nos cuidadores. Apesar da associação entre transtornos mentais/comportamentais e DTUI estar bem documentada na literatura, a investigação de sintomas psiquiátricos na prática clínica ainda é pouco realizada e deve ser estimulada.

Impact of adenotonsillectomy on nocturnal enuresis in children with sleep-disordered breathing: A prospective study.

OBJECTIVES/HYPOTHESIS: To investigate the relationship between sleep-disordered breathing (SDB) and nocturnal enuresis (NE) in children and to prospectively evaluate the effectiveness of adenotonsillectomy on resolving enuresis in indicated SDB patients with NE. METHODS: We prospectively collected data from 183 children (121 males, mean age 8.17 ± 2.84 years) who underwent adenotonsillectomy to treat SDB between July 2011 and July 2013, and analyzed the prevalence of NE. Before and 3 months after surgery, all parents were requested to answer a self-reported SDB scale questionnaire (22 questions, 0-22 points) and a NE questionnaire (episodes of enuresis per month). Paired t test, Student t test, and Chi-square test were used to analyze the data. RESULTS: Overall prevalence of NE was 9.3% (17 patients) preoperatively and 1.5% postoperatively (four patients). After adenotonsillectomy, prevalence of NE and the mean SDB scale were significantly decreased (both P values < 0.001). After adenotonsillectomy, 13 of the 17 NE patients (76.5%) showed complete resolution. There was significantly higher prevalence of NE in patients with obstructive sleep apnea (OSA) than those without OSA (13.1%, 14 of 107 vs. 3.9%, 3 of 76; P = 0.036). CONCLUSION: There is strong association between NE and SDB, and adenotonsillectomy can markedly improve enuresis in the majority of children with NE and SDB. LEVELS OF EVIDENCE: 4. Laryngoscope, 126:1241-1245, 2016.

Adenotonsillectomy Normalizes Hormones and Urinary Electrolytes in Children With Nocturnal Enuresis and Sleep-Disordered Breathing.

OBJECTIVE: To assess (1) plasma levels of antidiuretic hormone (ADH) and brain natriuretic peptide (BNP) and urinary levels of electrolytes in children with sleep disordered breathing (SDB), with or without nocturnal enuresis (NE), and (2) the effect of adenotonsillectomy (T&A) on urinary electrolytes and the secretion of ADH and BNP in children with NE and SDB. We previously reported post-T&A improvements in plasma levels of BNP and ADH in children with SDB and NE. However, the differences in plasma concentration of these hormones in SDB children with and without NE, and their relationships with urinary electrolytes, have not yet been addressed. METHODS: This prospective study compared concentrations of urinary electrolytes and plasma ADH and BNP in (1) children with SDB and NE (study group) and an age- and sex-matched control group of children with SDB without NE, and (2) the study group before and 1-month after T&A. RESULTS: Compared with the control group (n = 31), the study group (n = 37) exhibited significantly lower ADH (P = .04) and higher BNP (P = .009) plasma levels. The differences in urinary electrolytes were not significant. Post-T&A, the study group showed significantly decreased BNP (P = .018), urinary sodium-to-creatinine ratio (P = .02), and urinary calcium-to-creatinine ratio (P = .007) compared with the pre-T&A values. Post-T&A changes in urinary calcium were significantly correlated with changes in sodium excretion (P = .002) and in plasma levels of BNP (P <.001). CONCLUSION: The presence of NE is associated with altered ADH and BNP levels in children with SDB. T&A led to normalization of ADH and BNP, probably through a calcium- and sodium-dependent mechanism.

Adenotonsillectomy improves quality of life in children with sleep-disordered breathing regardless of nocturnal enuresis outcome.

BACKGROUND: Nocturnal enuresis (NE) and sleep-disordered breathing (SDB) have both been associated with impaired health-related quality of life (HRQoL). The following were investigated: (1) whether tonsillectomy and/or adenoidectomy (T&A) significantly affect the HRQoL in children with NE and SDB, and 2) differences in HRQoL between children with NE persistence versus resolution post-T&A. METHODS: This was a prospective study comparing the HRQoL of children with SDB and NE (study group) pre- and 4 weeks post-T&A, and the HRQoL of children with SDB without NE (control group) (independent t-tests). HRQol was assessed using the Obstructive Sleep Apnea Quality of Life 18 questionnaire (OSAS-18), a validated measure containing five subscales that combine to create a total score. Individual items were scored on a Likert-type scale ranging from 1 (none of the time) to 7 (all of the time). Symptoms of SDB were evaluated using the validated Pediatric Sleep Questionnaire (PSQ). Mixed ANOVA was conducted to evaluate changes in the measures between the wet and dry children post-T&A. Pre- and post-T&A change scores were calculated for both the PSQ and the OSAS-18. RESULTS: There were 30 children in the study group (18 male, mean age 9.07 years, SD 2.19), and 30 age-matched controls (16 male). There were no statistically significant differences between the two groups in regards to OSAS-18 total, PSQ total, BMI, diagnosis of snoring or OSAS on sleep study, or race. Overall, OSAS-18 and PSQ scores significantly improved in all children post-surgery (p < 0.001; p < 0.001, respectively), with no significant differences between dry and wet children post-T&A. The correlation between the pre- and post-T&A change scores on the OSAS-18 and PSQ was significant (r(29) = 0.58, p = 0.001), suggesting that a reduction in SDB symptoms post T&A is related to improved HRQoL. CONCLUSIONS: T&A significantly improved HRQoL in all children with SDB and NE, regardless of NE outcomes. These findings support recommendations for T&A in children with SDB with or without NE.

Effects of adenoidectomy/adenotonsillectomy on ADHD symptoms and behavioral problems in children.

OBJECTIVES: In children, the most common reason of upper airway obstruction (UAO) is adenotonsillar hypertrophy. In literature, the adverse effects of UAO and obstructive sleep apnea syndrome on behavior and attention in children have been reported in several articles. However, the methods used for the evaluation of behavioral disorders have not been standardized in those studies. The aim of this study was to investigate the behavioral and attention characteristics of children before and after adenoidectomy/adenotonsillectomy using an internationally valid method. METHODS: A total of 41 patients, between 6 and 11 years of age and having a medical history of UAO for at least one year for which adenotonsillectomy procedure was indicated, were enrolled in the study. The patients were evaluated for signs of attention/behavioral disorders by a child-adolescent psychiatrist and Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children: Present and Lifetime Version (K-SADS-PL) and The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), before and at the 6th month following the operation. RESULTS: In the preoperative period, a psychiatric disorder was identified by K-SADS-PL in 41.4% (n =1 7) of patients. Of these, 11 patients had attention deficit hyperactivity disorder (ADHD), 6 had enuresis nocturna, and 2 had separation anxiety disorder. Pre- and postoperative mean scores in T-DSM-IV-S parent scale were 31.3 ± 8.5 and 20.2 ± 10.3, respectively, and this difference was statistically significant (p < 0.001). CONCLUSION: The relationship of UAO and attention/behavioral disorders should be taken into consideration by child-adolescent psychiatrists together with ENT specialists and a multidisciplinary approach is important for the treatment team.

Monosymptomatic and non-monosymptomatic nocturnal enuresis: a clinical evaluation.

BACKGROUND: Nocturnal enuresis is divided into monosymptomatic nocturnal enuresis (MNE) and non-monosymptomatic nocturnal enuresis (NMNE). This study reviews clinical and ultrasonography (US) findings in enuretic children, and compares the organic and functional pathologies of the lower urinary tract (LUT) in children with MNE to those who have NMNE. METHODS: We enrolled 111 neurologically normal children with chief complaints of enuresis in this study. Participants included 60 boys and 51 girls, aged 5 - 17 years. There were 43 (38.8%) patients diagnosed with MNE and 68(61.2)% with NMNE. Urine analysis, urine culture and kidney-bladder US were performed for patients. Some patients underwent a voiding cystoureterography (VCUG), urodynamic study (UDS), or both.  RESULTS: Patients were divided into three groups: i) MNE, ii) NMNE without daytime incontinence (NMNE - daytime incontinence), and iii) NMNE plus daytime incontinence (NMNE + daytime incontinence). Constipation (P = 0.011), encopresis (P = 0.003) and urge incontinence (P = 0.001) were significantly more frequent in patients with NMNE +daytime incontinence. Bladder wall thickness (BWT) was the most common US finding. One patient with MNE and 9 with NMNE+ daytime incontinence had vesicoureteral reflux (VUR; P = 0.016). Posterior urethral valve (PUV) was reported in one patient with NMNE.  Evidence of bladder dysfunction was noted in about half of the patients who underwent UDS, with a higher prevalence in cases that had NMNE +daytime incontinence (P = 0.297). Bowel symptoms and VUR were significantly more prevalent in cases with NMNE + daytime incontinence.  CONCLUSION: We recommend VCUG in enuretic children who have daytime incontinence. In addition our study has revealed that symptoms suggestive of an overactive bladder (OAB) are not good indicators for bladder dysfunction.

Sleep patterns in pediatric sickle cell disease.

BACKGROUND: Research examining sleep in children with sickle cell disease (SCD) has focused on the increased occurrence of specific sleep disorders (i.e., sleep-disordered breathing, hypoxemia, nocturnal enuresis), but no research exists describing general sleep behaviors of children with SCD. The purpose of the current study was to compare sleep patterns and sleep behaviors in children with SCD and healthy controls and examine the associations of demographic and disease factors with sleep in the SCD group. PROCEDURE: The Children's Sleep Habits Questionnaire was completed by parents of 4- to 10-year-old children with SCD (n = 54) and children attending well-care clinics in the same urban hospital (n = 52). Within the SCD group, demographic and disease factors [i.e., genotype, healthcare utilization, SCD complications, and socioeconomic status (SES)] were determined by medical chart review. RESULTS: Parents of children with SCD reported significantly more behaviors associated with night waking and sleep-disordered breathing than the control group. Within the SCD group, parasomnias were related to SES, enuresis, more severe genotypes, SCD complications, and healthcare utilization. Sleep-disordered breathing was also related to SES, enuresis, and SCD complications. CONCLUSIONS: Results indicate the importance of routinely assessing sleep in children with SCD as they are more likely to exhibit disrupted sleep than children with similar demographic backgrounds. Given significantly higher rates of parent reported sleep-disordered breathing and night waking in this population, it is important to consider interventions to minimize disruptions to overnight sleep and improve daytime functioning for quality of life in children with SCD.

Enuresis nocturna y sindrome de disfunción evacuatoria en niños varones: respuesta al tratamiento con biofeedback urinario de vaciado / Nocturnal enuresis and voiding dysfunction syndrome in boys: response to treatment with biofeedback urinary drainage

La enuresis o síndrome de la "cama mojada" representan un porcentaje importante de la consulta diaria del pediatra y del urólogo pediatra. Se estima que entre el 15 y el 20% de los niños a los 5 años de edad mojan la cama (Moffatt 1994). El Síndrome de disfunción evacuatoria se asocia con mucha frecuencia a niñas enuréticas nocturnas. De los niños varones enuréricos un 20.9% presenta además incontinencia diurna y constipación. OBJETIVOS: demostrar que los niños enuréticos que asocian síntomas diurnos de incontinencia y constipación, presentan una incoordinación miccional por hábito retencionista y que mejoran con re-educación miccional mediante biofeedback de vaciado. MATERIAL Y METODOS: se estudiaron 50 niños que asociaban enuresis y síntomas diurnos de inestabilidad vesical y constipación. Fueron tratados mediante biofeedback urinario de vaciado, enseñando a los pacientes a relajar su periné durante la micción. Estadísticamente los resultados se obtuvieron con una alfa de 0.005 y una beta de 0.30. El delta observado en estudios previos fue bastante amplio de que no permitió obtener un power o poder del 70% con el estuido de 50 pacientes. RESUTLTADOS: La enuresis nocturna mejoró un 86%(p=<0,001), la urgencia mejoró del 98% al 8% y la incontinencia diurna paso de 7,22 veces por día a 0,36.(p=<0,001). La constipación mejoró de un promedio de 4,34 deposiciones por semana a 6,44(p=<0,001). CONCLUSIONES: El biofeedback urinario de vaciado resulto útil en el tratamiento de la enuresis y síntomas de vejiga hiperactiva así como de la constipación en niños portadores de síndrome de disfunción evacuatoria. No hubo diferencias significativas entre los resultados obtenidos en las dos primeras semana de tratamiento y al final (7 meses) lo que muestra la persistencia de los resultaods durante este tiempo...

Influence of high bladder pressure on vesicoureteral reflux and its resolution.

OBJECTIVES: Voiding dysfunction may result in lower urinary tract symptoms in children and is associated with urinary tract infection, renal damage and vesicoureteral reflux (VUR). The aim of this study was to assess the relationship between detrusor pressure, VUR and abnormal renal scintigraphy findings in children with dysfunctional voiding. PATIENTS AND METHODS: Between 2004 and 2007, 30 children with VUR and voiding dysfunction, 22 girls and 8 boys, median age 8.2 years, were evaluated. Urodynamic study, renal scan and voiding cystourethrography were performed in all patients. RESULTS: The degree of the renal scarring was found to be associated with the detrusor pressures (p = 0.018). The highest detrusor pressure was shown in the group of urge syndrome. The degree of the VUR was found to be correlated with the detrusor pressures (p = 0.038). In our study group, VUR had resolved in 11 (37%) patients, had improved in grade in 10 (33%) patients and remained unchanged in 9 (30%) patients after anticholinergic therapy. No significant relationship was found between the duration of therapy and the voiding patterns (p = 0.389). CONCLUSION: Every child with VUR should undergo a careful evaluation of its bladder function. The patients who have high detrusor pressures should be evaluated carefully for the presence of VUR and renal damage.

Symptoms of sleep-disordered breathing in children with nocturnal enuresis.

OBJECTIVES: There is an association between sleep-disordered breathing (SDB) and nocturia in adults, raising the question as to whether SDB could play a role in the aetiology of nocturnal enuresis (NE) in children. The aim of this study was to determine whether there is an association between these two conditions. METHODS: The study group comprised 40 patients, aged 5-15 years, with enuresis and the control group 40 children undergoing routine day-case surgery. Subjects completed a Pediatric Sleep Questionnaire (PSQ) and a questionnaire assessing lower tract symptoms. Categorical variables were analysed using Pearson's Xi(2) test, and group differences for continuous variables using Mann-Whitney and Kruskal-Wallis tests or t-tests according to the distribution of data. RESULTS: The groups were well matched. Patients with NE had significantly higher total PSQ scores (P<0.001). PSQ subscales relating to daytime sleepiness (P<0.003) and daytime behaviour (P<0.000) were significantly worse in NE patients. The snoring subscale was not statistically different (P<0.051), but a comparison of females alone showed a highly significant difference (P<0.001) with higher snoring subscale scores in girls with NE. CONCLUSION: Children with NE had significantly higher PSQ scores. The data suggest an association between NE and SDB in girls. The significantly higher level of reports of daytime sleepiness and behavioural problems in all NE children warrants further study to determine the potential causative pathways and clinical relevance of these findings. SDB could be usefully assessed in children with NE, particularly when they do not respond to standard treatment.

Prevalence of adenoid hypertrophy and nocturnal enuresis in primary school children in Istanbul, Turkey.

OBJECTIVE: The purpose of this study is to investigate the prevalence of an existing relationship between adenoid hypertrophy and nocturnal enuresis in primary school children. METHODS: The study was performed in four primary schools that were chosen randomly in Kartal, Istanbul. The children's parents were asked to fill out a questionnaire that included questions concerning the associated symptoms of adenoid hypertrophy and nocturnal enuresis. The interrelations between adenoid hypertrophy and nocturnal enuresis items were examined by X2 tests. RESULTS: The study population consisted of 1132 (625 girls, 621 boys) primary school children between 5 and 14 years of age (mean 9.59+/-2.60 years). The children were divided into three groups with 5-7 years old children in Group I (n=232), 8-10 years old children in Group II (n=506) and 11-14 years old children in Group III (n=394). Of the 1132 distributed questionnaires, 1090 (87.4%) were filled in adequately and were accepted for evaluation. Prevalence of adenoid hypertrophy in school children was found to be 58 in Group I (27%), 94 in Group II (19.5%) and 78 in Group III (19.9%). Prevalence of nocturnal enuresis in school children was found to be 35 in Group I (15.1%), 51 in Group II (10.1%) and 18 in Group III (4.6%). No statistically significant association was present between adenoid hypertrophy and nocturnal enuresis in either Group I, II or III school children. CONCLUSION: In contrast to previous studies, our prevalence study did not find an association between adenoid hypertrophy and nocturnal enuresis. Thus, this prevalence study provides otolaryngologists new and interesting information.