RESUMEN
Objective:To discover the clinical features of nocturnal enuresis (NE) in adults and to detect factors that correlated with the symptom severity.Methods:This cross-sectional study recruited NE subjects from September 2017 through December 2020. All patients had experienced enuresis at least once per week and with a symptom duration of 3 months or longer. Followed by documentation of history and medical records, three-day bladder diary was adopted to assess their voiding pattern, and urodynamic parameters were obtained to evaluate lower urinary tract function.Results:A total of 106 NE patients (43 male and 63 female) were identified. There is no statistical difference regarding the average age (men: 57.8±15.6 vs. women: 56.1±14.0, P>0.05) and BMI (men: 23.9±3.4 vs. women: 23.3±4.3, P>0.05) between men and women. Comorbidities are extremely common in NE patients (n=85, 80.2%), with the incidence rate higher in men compared to women [88.4% (38/43)vs. 74.6% (47/63), P<0.05]. Hypertension (n=58, 54.7%), hyperlipemia (n=41, 38.7%), diabetes mellitus (n=38, 35.8%), coronary heart disease (n=22, 20.8%) were the most frequently reported conditions. On bladder diaries, subjects were frequently manifested nocturnal polyuria (NP, 47/106, 44.3%), reduced nocturnal bladder capacity (NBC, 74/106, 69.8%), or combination of both(33/106, 31.3%). Urodynamic studies suggested that the incidence of reduce bladder compliance, detrusor overactivity (DO), stress incontinence, bladder outlet obstruction(BOO), detrusor underactivity(DU)and detrusor hyperreflexia with impaired contractility(DHIC)was 27.4%(29/106), 39.6%(42/106), 17.9%(19/106), 9.4%(10/106), 25.5%(27/106)and 15.1%(16/106), respectively. Women were more likely to suffer from stress urinary incontinence [2.3%(1/43) men vs. 28.6% (18/63) women, P<0.01], while men were prone to have bladder outlet obstruction [ 23.3%(10/43) men vs. 0 women, P<0.01]. Correlation analysis demonstrated that obesity( r=0.63, P<0.01), systemic comorbidities( r=0.40, P<0.01), presence of NP( r=0.50, P<0.01) and NP+ NBC( r=0.47, P<0.01), post-void residual( r=0.53, P<0.01), reduced compliance( r=0.21, P=0.04), DU( r=0.28, P<0.01), stress incontinence( r=0.42, P<0.01)and DHIC ( r=0.35, P<0.01)are positively correlated with NE severity. Whereas, reduced Q max( r=-0.35, P<0.01), low capacity( r=0.21, P=0.03), and reduced bladder sensation( r=-0.21, P=0.03) correlate negatively with NE severity. Conclusions:The presence of NE is not only a sign of bladder dysfunction, but also an implication of obesity, systematic chronic diseases, urine production malfunctioning. Therefore, a thorough history regarding the lower urinary tract function and systemic comorbidities should be taken carefully, so that, an integrated and personalized treatment can be carried out.
RESUMEN
PURPOSE: We investigated the results of voiding parameters according to the subtypes of audiovisual stimulation (AVS)- and sexual stimulation (SS)-penogram in patients with both erectile dysfunction (ED) and lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: Sixty seven patients with ED and LUTS were included in this study. Erectile function was evaluated by international index of erectile function (IIEF)-5, AVS-penogram, and SS-penogram. After AVS-penogram, SS-penogram was performed 30 minutes after taking mirodenafil (100mg) orally. We also evaluated voiding function with international prostatic symptom score (IPSS), quality of life score (QoL), urinary flow rate (UFR), residual urine volume (RV), and transrectal ultrasonograpy (TRUS). Voiding functionparameters were analyzed according to the subtypes of AVS- and SS-penogram. RESULTS: Although there was tendency that the IIEF-5 scores were lower in patients who showed decreased erectile responses on AVS-penogram, but it did not reach the statistical significance (p= 0.09). The RV was significantly increased as the erectile function worsens based on AVS-penogram (p= 0.003). However, no significant relationship was found betweenresults of SS-penogram and voiding function parameters. CONCLUSIONS: Our results revealed some relationship between voiding function and erectile function evaluated by AVS-penogram, but not by SS-penogram, in patients with both ED and LUTS. AVS-penogram, as well as IIEF questionnaire, may play an important role in predicting voiding function in patient with both conditions .