Urodynamic studies in children with primary nocturnal enuresis

Twenty five children with primary nocturnal enuresis were studied by cystometry, uroflowmetry and uretheral profilometry. Ninety two percent of the studied children had abnormal cystometrograms showing hyperreflexic bladder with high resting pressure in 76%, small bladder capacity in 68% and uninhibited bladder contractions in 36% and by uroflowmetry 12% were supervoiders. These urodynamic abnormalities were more prominent with a significantly high percentage of small bladder capacity in children over 10 years of age. All studied children had a normal uretheral closure pressure by uretheral profilometry. Abnormal uroflowmetry in the form of supervoiding was very prominent in children with psychological problems. There were no significant differences in the cystometric and uroflowmetric findings of enuretic children with and without a family history of enuresis although uninhibited bladder contractions were more common in children with a positive family history indicating a defect in the central rather than the peripheral control of mictruition. It is concluded that children with primary nocturnal enuresis exhibit significant cystometric abnormalities that may reflect a delayed maturation of the controlling central and peripheral nervous system and which may benefit from proper anticholinergic theapy. Supervoiding might indicate the presence of psychologic problem that necessitates psychotherapy