ABSTRACT
PURPOSE: There is a known association between sickle cell disease and enuresis. However, the cause of this association is unclear. We tested the hypothesis that children with sickle cell disease would have more symptoms of overactive bladder than a control group. MATERIALS AND METHODS: Questionnaires were distributed to 155 legal guardians of children and adolescents 5 to 17 years old with sickle cell disease and to 100 legal guardians of a control group of children. RESULTS: Individuals with and without sickle cell disease were distributed uniformly regarding gender and age. A total of 50 patients (32.3%) in the sickle cell disease group had enuresis vs 5 (5%) in the control group (p = 0.000). Daytime urinary incontinence was observed in 36 individuals with (23.2%) and 11 (11.0%) without sickle cell disease (p = 0.014). A total of 52 patients with sickle cell disease (33.5%) complained of urgency, compared to 10 controls (10%, p = 0.000). A total of 49 patients with sickle cell disease (31.6%) had frequency, compared to 6 controls (6%, p = 0.000). Of all patients who reported enuresis or daytime incontinence only 1 with enuresis had received specific treatment. CONCLUSIONS: There is a significant association between sickle cell disease and enuresis and overactive bladder symptoms such as daytime incontinence, urgency and frequency. Thus, all children and adolescents with sickle cell disease should be questioned regarding the presence of these symptoms to facilitate treatment for these conditions.
Subject(s)
Anemia, Sickle Cell/complications , Enuresis/epidemiology , Enuresis/etiology , Urinary Incontinence/epidemiology , Urinary Incontinence/etiology , Adolescent , Brazil/epidemiology , Case-Control Studies , Child , Female , Humans , Male , Prevalence , Surveys and QuestionnairesABSTRACT
Diabetic autonomic bladder dysfunction is rare in the pediatric age group. An adolescent girl aged 16 years and 7 months, with type 1 diabetes mellitus since the age of 6 years, was diagnosed as having diabetic cystopathy. Ultrasonography of the urinary tract showed a distended bladder with normal kidneys. Laboratory evaluation revealed: normal serum urea, creatinine and electrolytes and elevated microalbuminuria. Urodynamic study demonstrated an impaired bladder sensation, increased cystometric capacity and detrusor arreflexia. Although more prevalent in adults and the elderly, autonomic bladder dysfunction must be considered in adolescents with type 1 diabetes mellitus.
