Application of urodynamics in the diagnosis and treatment of childhood nonmonosym ptomatic nocturnal enure-sis / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the application of urodynamics in the diagnosis and treatment of nonmonosymp-tomatic nocturnal enuresis(NMNE)in children,and to provide some evidence for its clinical treatment. Methods Patients who were clinically diagnosed as NMNE at Department of Pediatrics Kidney Rheumatism and Pediatric Urology of Shengjing Hospital of China Medical University from January 2015 to August 2016 were collected. Sixty - six children with NMNE were included in the urodynamic study,and the different treatments were selected according to the results of the urodynamics and the efficacy was evaluated. Results The urodynamic results of 61 patients(92. 43％)were abnor-mal,and 5 cases(7. 57％)had no abnormalities. There were 35 cases with overactive bladder(OAB)in abnormal re-sults,with a remarkable decrease in bladder pressure capacity in 7 cases,detrusorsphincter discoordination(DSD)in 1 case,and OAB with other abnormal results in 18 cases. OAB was found in 53 cases,and the detection rate was 86. 89％(53 / 61 cases),accounting for 80. 3％(53 / 66 cases)of the total samples. The desmopressin acetate combined with Tolterodine tartrate was used to treat OAB patients,and its total effective rate was 94. 34％(50 / 53 cases). The biofeed-back treatment had effect on DSD child. The patients with a marked decrease in bladder pressure capacity and with the normal urodynamics received desmopressin acetate joint behavior training treatment,and the efficiency of the therapy was 71. 43％(5 / 7 cases)and 80. 00％(4 / 5 cases),respectively. Conclusions The urodynamics study can uncover the pathophysiological mechanism of NMNE,so this examination is essential for NMNE children to improve the treat-ment. Since the rate of OAB in NMNE is very high,it is suggested that anticholinergic medications combined with desmopressin can be used in the initial treatment of the NMNE patients to improve the rate of cure and prognosis.