Abstract
Objective: Nocturnal enuresis and constipation are common pediatric problems. The aim of this study was to assess the incidence of constipation in children with or without monosymptomatic primary nocturnal enuresis.Methods: The study included 5350 children, ages 5–19 years, who were surveyed to detect the incidence of nocturnal enuresis. Of those surveyed, 679 (12.7%) had primary nocturnal enuresis. All children were questioned by mail with a standard form that addressed their micturition and defecation habits. The children those who had primary nocturnal enuresis were invited to the Pediatric Urology Section of the University Hospital. Of those 679 children, 125 kept that invitation. All 125 of those children underwent an abdominal ultrasound. Also, these children had serum creatinine levels drawn and plain abdominal films taken.Results: Constipation, defined as less than 3 bowel movements per week, was seen in 48 of 679 children with nocturnal enuresis (7.06%). Of those 4671 children without nocturnal enuresis, only 68 (1.45%) had constipation. The difference in constipation between the two groups was statistically significant (z = −9.251; p = 0.000). Of note, 10 of the 125 children (8%), evaluated at the hospital, had constipation. None of the children had an abnormal neurologic examination. Finally, faecal loading was detected on the plain films of 8 of the 125 children evaluated, 7 of who had constipation. The sensitivity of grading plain films for faecal loading to denote constipation in this population was 87.5%.Conclusions: Children with primary nocturnal enuresis should be thoroughly assessed for coexisting constipation.
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References
Serel TA, Akhan G, Koyuncuoglu HR et al. Epidemiology of enuresis in Turkish children. Scand J Urol Nephrol 1997; 31: 537–539
Lackgren G, Hjalmas K, von Gool J et al. Nocturnal enuresis: a suggestion for a European treatment strategy. Acta Paediatr 1999; 88: 679–690
Loening-Baucke V. Urinary incontinence and urinary tract infection and their resolution with treatment of chronic con-stipation of childhood. Pediatrics 1997; 100: 228–232
Koff SA, Theodore TW, and Jayanthi VR. The relation-ship among dysfunctional elimination syndromes, primary vesicoureteral reflux and urinary tract infections in children.J Urol 1998; 160: 1019–1022
Dohil R, Roberts E, Jones KV et al. Constipation and revers-ible urinary tract abnormalities. Arch Dis Child 1994; 70: 56–57
O'Regan S, Yazbeck S, Schick E. Constipation, bladder in-stability, urinary tract infection syndrome. Clin Nephrol 1985; 23: 152–154
O'Regan S, Schick E, Hamburger B et al. Constipation asso-ciated with vesicoureteral reflux. Urology 1986; 28: 394–396
Swenson O. A new concept in the pathology of megaloureters. Surgery 1952; 32: 367
Blethyn AJ, Jones KV, Newcombe R et al. Radiological as-sessment of constipation. Arch Dis Child 1995; 73: 532–533
McClung HJ, Boyne LJ, and Linsheid T.Is combination ther-apy for encopresis nutritionally safe?Pediatrics 1993; 91: 591–594
Rushton HG. Wetting and functional voiding disorders. Urol Clin North Am 1995; 22: 75–93
O'Regan S, Yazbeck S. Constipation: A cause of enuresis, urinary tract infection and vesico-ureteric reflux in children. Med Hypotheses 1985; 17: 409–413
Weiss R, Tamminen-Mobius T, Koskimies O et al. Character-istics at entry of children with severe primary vesicoureteral reflux recruited for a multicenter, international therapeutic trial comparing medical and surgical management. The interna-tional reflux study in children. J Urol 1992; 148: 1644–1649
Greenfield SP, Ng M, Wan J. Experience with vesicoureteral reflux in children: clinical characteristics. J Urol 1997; 574–577
Bailey JA, Powers JJ, Waylonic GW. A clinical evaluation of electromyography of the anal sphincter. Arch Phys Med Rehabil 1970; 403–408
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Çayan, S., Doruk, E., Bozlu, M. et al. The assessment of constipation in monosymptomatic primary nocturnal enuresis. Int Urol Nephrol 33, 513–516 (2001). https://doi.org/10.1023/A:1019546108685
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DOI: https://doi.org/10.1023/A:1019546108685