Clinical Investigation

The Differences in Diagnosis, Treatment and Follow up in Primary and Secondary Enuresis Nocturna in Children

  • Tolga ÜNÜVAR
  • Ferah SÖNMEZ
  • Gülten INAN

Received Date: 21.04.2004 Accepted Date: 20.07.2004 Meandros Med Dent J 2005;6(1):9-13

Aims: In this study, we planned to evaluate the response to the medical treatment, the need for laboratory investigations in, primary and secondary enuretic children and to compare the results between former and the latter. Materials and methods: This research was done in 169 children (mean age 9,48 2,60 (5-15), 59,2% male) who had the diagnosis of primary and secondary monosymptomatic enuresis nocturna. Before the treatment, blood glucose level, renal function tests, presence of parasite in faeces, urine analysis, urine culture and renal ultrasound were assessed in all of the patients. According to the results of these tests one of the following treatment strategies were planned behavioural therapy, alarming device, imipramine, desmopressine nazal spray and if necessary oxibutinine. The results were evaluated with chi square test in SPSS 10,0 programme. Results: Among children who applied to our outpatient clinic with complaint of bed wetting, 85,2% had primary enuresis and 14,8% had secondary enuresis. The rate of secondary enuresis diurna was 12,2%. Family history of enuresis was present in 78,7% of children. Eighty four percent of children who applied to our outpatient clinic had never taken any treatment. Blood glucose levels, renal function tests and renal ultrasound were normal in all. 3,6% of the children had urinary infection detected by urine culture. Parasites were detected in faeces in 13,6% of children. There was no significant difference in sex, family history, present of parasite, frequency of enuresis diürna and encopresis between primary and secondary enuretics. Primary enuretics were found to have higher frequency of enuresis than secondary enuretics. Urine analysis and urine culture were more significantly pathologic in secondary enuretics compared to primary enuretics. Response to behaviour therapy was better in primary enuretics than secondary enuretics. We didn't find a significant difference between primary and secondary enuretics, in different treatment models. Conclusion: Urine analysis and parasite search in feaces should be done in children who present with enuresis nocturna, especially ones with secondary reasons. In addition, whether there is any underlying reason is present or not, such a cause should be searched and suitable treatment should be given. Conditioning therapy as an affurtable and easy treatment option should be the initial choice for used in primary enuretics.

Keywords: Enuresis nocturna, diagnosis, treatment