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Fumihiko Ikoma - One of the best experts on this subject based on the ideXlab platform.
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Lower urinary tract problems in patients with Enuresis.
European urology, 1998Co-Authors: Hiroki Shima, Yoshinori Mori, Michio Nojima, Iwai Miyamoto, Hirofumi Chokyu, Fumihiko IkomaAbstract:Two hundred and thirty-eight children (170 males, and 68 females) with nocturnal Enuresis were retrospectively studied for lower urinary tract problems. Surgical correction of subclinical organic obstruction in the lower urinary tract was evaluated for the improvement of bed-wetting. One hundred and fifty-five micturating cystourethrography (MCU), and 89 urodynamic studies were performed. Optic internal urethrotomy was done in a boy, and meatoplasty in a girl for urethral 'ring' stenosis (URS). Nocturnal Enuresis was found in 153 cases and nocturnal Enuresis associated with daytime Enuresis in 67 cases. Vesicoureteral reflux was found in 30, URS in 42, and posterior urethral valve in 3 cases on MCU. Detrusor instability was recognized in 39.4% of 38 cases of nocturnal Enuresis associated with daytime Enuresis and in 25.0% of 51 cases of nocturnal Enuresis. Surgery brought 73.8% improvement of bed-wetting in 42 cases. Surgical correction of subclinical obstruction in the lower urinary tract might contribute to the earlier resolution of bed-wetting in children with nocturnal and/or diurnal Enuresis.
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Lower urinary tract problems in patients with Enuresis
European Urology, 1998Co-Authors: Hiroki Shima, Yoshinori Mori, Michio Nojima, Iwai Miyamoto, Hirofumi Chokyu, Fumihiko IkomaAbstract:Objective(s): Two hundred and thirty-eight children (170 males, and 68 females) with nocturnal Enuresis were retrospectively studied for lower urinary tract problems. Surgical correction of subclinical organic obstruction in the lower urinary tract was evaluated for the improvement of bed-wetting. Methods: One hundred and fifty-five micturating cystourethrography (MCU), and 89 urodynamic studies were performed. Optic internal urethrotomy was done in a boy, and meatoplasty in a girl for urethral ‘ring’ stenosis (URS). Results: Nocturnal Enuresis was found in 153 cases and nocturnal Enuresis associated with daytime Enuresis in 67 cases. Vesicoureteral reflux was found in 30, URS in 42, and posterior urethral valve in 3 cases on MCU. Detrusor instability was recognized in 39.4% of 38 cases of nocturnal Enuresis associated with daytime Enuresis and in 25.0% of 51 cases of nocturnal Enuresis. Surgery brought 73.8% improvement of bed-wetting in 42 cases. Conclusions: Surgical correction of subclinical obstruction in the lower urinary tract might contribute to the earlier resolution of bed-wetting in children with nocturnal and/or diurnal Enuresis.
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Congenital lower urinary tract obstruction and Enuresis in children
The Japanese Journal of Urology, 1991Co-Authors: Yoshinori Mori, Keizou Taguchi, Shouzou Hosokawa, Hideari Ihara, Hiroki Shima, Kenji Shimada, Masaaki Arima, Fumihiko IkomaAbstract:We reviewed enuretic children among patients with congenital lower urinary tract obstructions experienced in the Department of Urology, Hyogo College of Medicine during 16 years from 1974 to 1989. Among 612 patients with congenital lower urinary tract obstructions, 139 (22.7%) had Enuresis nocturna and/or diurna. The incidence of Enuresis was 24.7% with posterior urethral valve (77 cases), 50.0% with anterior urethral valve (6 cases), 23.8% with congenital bulbar urethral stenosis in boys (303 cases) and 19.9% with congenital distal urethral stenosis in girls (226 cases). Diurnal Enuresis was more common in Enuresis associated with congenital lower urinary tract obstructions than in usual Enuresis. In urodynamic examinations, more than half of enuretic children with congenital lower urinary obstructions showed hyperactive detrusor activity. Treatment of congenital lower urinary tract obstructions through operation resulted in cure or amelioration of Enuresis in about 80% of the patients. Enuresis associated with lower urinary tract obstruction or neurogenic bladder is sometimes called complicated Enuresis and it is an important role of a urologist to differentiate complicated Enuresis from simple Enuresis.
Richard P. Millman - One of the best experts on this subject based on the ideXlab platform.
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Enuresis and Obstructive Sleep Apnea in Adults
Chest, 1998Co-Authors: Naomi R. Kramer, Alice E. Bonitati, Richard P. MillmanAbstract:Adult Enuresis is an unusual symptom of obstructive sleep apnea (OSA). Although it is described as a classic symptom of childhood OSA, Enuresis is encountered infrequently in adult sleep medicine. Five adults with Enuresis associated with sleep apnea presented to our Sleep Disorders Center. In all five cases, the onset of Enuresis was associated with the progression of sleep apnea symptoms. In each case, the Enuresis resolved with treatment with nasal continuous positive airway pressure. Current medical literature on the postulated mechanisms of nocturia and Enuresis in sleep apnea is reviewed. Based on the experience of the authors and review of the medical literature, one may conclude that severe OSA may lead to new-onset Enuresis in adults and that effective treatment of OSA is associated with resolution of Enuresis.
Oscar Sans Capdevila - One of the best experts on this subject based on the ideXlab platform.
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Enuresis and Obstructive Sleep Apnea in Children
Sleep Disordered Breathing in Children, 2012Co-Authors: Oscar Sans Capdevila, Maria Eugenia Russi DelfraroAbstract:Nocturnal Enuresis is a common problem, affecting an estimated 5 to 7 million children in the United States alone and occurring three times more often in boys than in girls. Nocturnal Enuresis is clinically and pathogenetically a heterogeneous disorder. A significant correlation between Enuresis and obstructive sleep-disordered breathing has been described in the last decade, with a high prevalence of Enuresis in those patients. It seems clear that increased upper airway resistance during sleep manifesting either as habitual snoring (HS) or as polysomnographically documented obstructive sleep apnea syndrome (OSA), increases the risk of Enuresis. Most importantly, after successful treatment of the respiratory disorder during sleep, bedwetting can be reduced or even eliminated. The goal of this chapter is to review the epidemiology, etiology, pathophysiology (specially the link with sleep disordered breathing), treatment and future areas of research for nocturnal Enuresis.
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increased morning brain natriuretic peptide levels in children with nocturnal Enuresis and sleep disordered breathing a community based study
Pediatrics, 2008Co-Authors: Oscar Sans Capdevila, Valerie Mclaughlin Crabtree, Leila Kheirandishgozal, David GozalAbstract:INTRODUCTION Habitual snoring and obstructive sleep apnea have been associated with bed-wetting in children, and effective obstructive sleep apnea treatment may improve Enuresis. OBJECTIVES The purpose of this work was to assess whether habitual snoring is associated with increased incidence of Enuresis and whether severity of obstructive sleep apnea correlates with enuretic frequency and to evaluate brain natriuretic peptide levels. METHODS Parental surveys of 5- to 7-year-old children were reviewed for habitual snoring and Enuresis. Enuresis was also assessed in a cohort of 378 children with habitual snoring undergoing overnight polysomnographic evaluation, and brain natriuretic peptide plasma levels were determined in 20 children with obstructive sleep apnea, 20 with habitual snoring without obstructive sleep apnea, and 20 nonsnoring children, matched for Enuresis. RESULTS There were 17,646 surveys completed (50.6% boys; 18.3% black). A total of 1976 (11.2%) of these children were habitual snoring (53% boys; 25.2% black). A total of 531 habitual snoring children also had Enuresis (26.9%), with a predominant representation of boys (472 boys [87.5%]). Among the 15670 nonsnoring children, Enuresis was reported in 1821 children (11.6%), of whom 88.8% were boys. However, Enuresis among 378 children with habitual snoring did not correlate with the magnitude of sleep respiratory disturbances. Indeed, Enuresis was reported in 33 of 149 children with obstructive sleep apnea (obstructive apnea hypopnea index: >2 per hour of total sleep time; 53% boys) as compared with 36 habitual snoring children with Enuresis (62% boys) and obstructive apnea hypopnea index <2 per hour of total sleep time. Brain natriuretic peptide levels were elevated among children with Enuresis and were marginally increased among children with obstructive sleep apnea. CONCLUSIONS Habitual snoring is associated with increased prevalence of Enuresis, and brain natriuretic peptide levels are increased in enuretic children with further increases with obstructive sleep apnea. However, the prevalence of Enuresis is not modified by severity of sleep disturbance. Even mild increases in sleep pressure because of habitual snoring may raise the arousal threshold and promote Enuresis, particularly among prone children, that is, those with elevated brain natriuretic peptide levels.
Michael R. Debaun - One of the best experts on this subject based on the ideXlab platform.
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Nocturnal Enuresis in sickle cell disease
Expert review of hematology, 2014Co-Authors: Rachel B. Wolf, Adetola A. Kassim, Robert L Goodpaster, Michael R. DebaunAbstract:Nocturnal Enuresis is a prevalent and challenging problem in children and young adults with sickle cell disease (SCD). Limited progress has been made in elucidating etiology and pathophysiology of nocturnal Enuresis in individuals with SCD. Among adults with SCD ages 18–20 years, approximately 9% report nocturnal Enuresis. Nocturnal Enuresis contributes to decreased health related quality of life in people with SCD, resulting in low self-esteem and sometimes social isolation. Postulated non-mutually exclusive causes of nocturnal Enuresis in individuals with SCD include hyposthenuria leading to nocturnal polyuria, decreased bladder capacity or nocturnal bladder overactivity, increased arousal thresholds, and sleep disordered breathing. No evidence-based therapy for nocturnal Enuresis in SCD exists. This review is focused on describing the natural history, postulated causes and a rational approach to the evaluation and management of nocturnal Enuresis in children and adults with SCD.
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Enuresis is a common and persistent problem among children and young adults with sickle cell anemia
Urology, 2008Co-Authors: Joshua J Field, Paul F Austin, Yan Yan, Michael R. DebaunAbstract:OBJECTIVES Enuresis and nocturia are common among children with sickle cell anemia (SCA). The objectives of this study were to describe the prevalence of Enuresis and nocturia among children and young adults with SCA and determine the relationship, if any, between these symptoms and SCA-related morbidity. METHODS A prospective infant cohort of African-American children with SCA was previously established from the Cooperative Study for Sickle Cell Disease. Included in this cohort were children with SCA enrolled before 6 months of age for whom questions about Enuresis and nocturia had been completed. RESULTS A total of 213 participants were included in this analysis. Sixty-nine individuals (33%) experienced Enuresis over the course of the study. No children under 6 years of age were asked about Enuresis. Thereafter, Enuresis was most prevalent between the ages of 6 and 8 years (42%) and continued to be common in young adults ages 18 to 20 years (9%). Seventy-nine percent of individuals reported a history of nocturia. There was no association between Enuresis or nocturia and an increased rate of pain or acute chest syndrome (ACS) episodes. CONCLUSIONS Enuresis and nocturia are common in children with SCA. Among adults with SCA, Enuresis and nocturia are more persistent compared with adults in the general population. Enuresis and nocturia are not associated with an increased rate of pain or ACS.
Hiroki Shima - One of the best experts on this subject based on the ideXlab platform.
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Lower urinary tract problems in patients with Enuresis.
European urology, 1998Co-Authors: Hiroki Shima, Yoshinori Mori, Michio Nojima, Iwai Miyamoto, Hirofumi Chokyu, Fumihiko IkomaAbstract:Two hundred and thirty-eight children (170 males, and 68 females) with nocturnal Enuresis were retrospectively studied for lower urinary tract problems. Surgical correction of subclinical organic obstruction in the lower urinary tract was evaluated for the improvement of bed-wetting. One hundred and fifty-five micturating cystourethrography (MCU), and 89 urodynamic studies were performed. Optic internal urethrotomy was done in a boy, and meatoplasty in a girl for urethral 'ring' stenosis (URS). Nocturnal Enuresis was found in 153 cases and nocturnal Enuresis associated with daytime Enuresis in 67 cases. Vesicoureteral reflux was found in 30, URS in 42, and posterior urethral valve in 3 cases on MCU. Detrusor instability was recognized in 39.4% of 38 cases of nocturnal Enuresis associated with daytime Enuresis and in 25.0% of 51 cases of nocturnal Enuresis. Surgery brought 73.8% improvement of bed-wetting in 42 cases. Surgical correction of subclinical obstruction in the lower urinary tract might contribute to the earlier resolution of bed-wetting in children with nocturnal and/or diurnal Enuresis.
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Lower urinary tract problems in patients with Enuresis
European Urology, 1998Co-Authors: Hiroki Shima, Yoshinori Mori, Michio Nojima, Iwai Miyamoto, Hirofumi Chokyu, Fumihiko IkomaAbstract:Objective(s): Two hundred and thirty-eight children (170 males, and 68 females) with nocturnal Enuresis were retrospectively studied for lower urinary tract problems. Surgical correction of subclinical organic obstruction in the lower urinary tract was evaluated for the improvement of bed-wetting. Methods: One hundred and fifty-five micturating cystourethrography (MCU), and 89 urodynamic studies were performed. Optic internal urethrotomy was done in a boy, and meatoplasty in a girl for urethral ‘ring’ stenosis (URS). Results: Nocturnal Enuresis was found in 153 cases and nocturnal Enuresis associated with daytime Enuresis in 67 cases. Vesicoureteral reflux was found in 30, URS in 42, and posterior urethral valve in 3 cases on MCU. Detrusor instability was recognized in 39.4% of 38 cases of nocturnal Enuresis associated with daytime Enuresis and in 25.0% of 51 cases of nocturnal Enuresis. Surgery brought 73.8% improvement of bed-wetting in 42 cases. Conclusions: Surgical correction of subclinical obstruction in the lower urinary tract might contribute to the earlier resolution of bed-wetting in children with nocturnal and/or diurnal Enuresis.
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Congenital lower urinary tract obstruction and Enuresis in children
The Japanese Journal of Urology, 1991Co-Authors: Yoshinori Mori, Keizou Taguchi, Shouzou Hosokawa, Hideari Ihara, Hiroki Shima, Kenji Shimada, Masaaki Arima, Fumihiko IkomaAbstract:We reviewed enuretic children among patients with congenital lower urinary tract obstructions experienced in the Department of Urology, Hyogo College of Medicine during 16 years from 1974 to 1989. Among 612 patients with congenital lower urinary tract obstructions, 139 (22.7%) had Enuresis nocturna and/or diurna. The incidence of Enuresis was 24.7% with posterior urethral valve (77 cases), 50.0% with anterior urethral valve (6 cases), 23.8% with congenital bulbar urethral stenosis in boys (303 cases) and 19.9% with congenital distal urethral stenosis in girls (226 cases). Diurnal Enuresis was more common in Enuresis associated with congenital lower urinary tract obstructions than in usual Enuresis. In urodynamic examinations, more than half of enuretic children with congenital lower urinary obstructions showed hyperactive detrusor activity. Treatment of congenital lower urinary tract obstructions through operation resulted in cure or amelioration of Enuresis in about 80% of the patients. Enuresis associated with lower urinary tract obstruction or neurogenic bladder is sometimes called complicated Enuresis and it is an important role of a urologist to differentiate complicated Enuresis from simple Enuresis.