Nappo S, Del Gado R, Chiozza M L, Biraghi M, Ferrara P, Caione P
Division of Pediatric Urology, 'Bambino Gesù', Children's Hospital, IRCCS, Rome, Italy.
BJU Int. 2002 Dec;90(9):912-7. doi: 10.1046/j.1464-410x.2002.03030.x.
To assess the features of adolescent bedwetters, as few data are available on enuresis in this age group.
A specific database for adolescents and young adults was created with the collaboration of various specialists (paediatricians, urologists, gynaecologists, psychiatrists). Questions focused on family and personal history, stressful events, age of attaining urinary and fecal control, characteristics of enuresis (primary vs secondary, monosymptomatic vs enuresis associated with daytime urinary symptoms), school performance, diagnostic examination and physical examinations, and treatment and its response.
Data were collected from 107 enuretic adolescents (mean age 15.3 years, median 14, range 13-23; 63 males and 44 females). A positive family history for enuresis was recorded in 82%. Enuresis was primary in 79 patients (74%), secondary in 28 (26%), monosymptomatic in 76 (71%) and associated with daytime urinary symptoms in 31 (29%). In males monosymptomatic enuresis was significantly more frequent than in females (P < 0.01). Urinary tract infections were reported by 13 patients, all females; eating disorders (anorexia, polyphagia) were present in six. In 85 patients (80%) enuresis was considered severe (> or = three nights/week). Of the 107 patients, 27 (20%) had never consulted a doctor about their problem and 43 (40%) had received no therapy; 66 received desmopressin monotherapy, with a good response (half the number of wet nights) in 44 (79%). There was no relation between response to desmopressin and gender, age, type and severity of enuresis or positive family history of enuresis. Eight patients were provided with a nocturnal alarm but this was not tolerated by two. Altogether, 25 patients refused any therapy or did not comply with the given therapy.
Enuresis can persist into adolescence and be a significant problem; 80% of these patients had severe enuresis and 31% also had associated daytime urinary symptoms, with 40% receiving no previous therapy. The treatment of enuresis can be particularly difficult at this age; 22% of patients did not respond to desmopressin and 23% had low compliance with the given therapy. Enuresis in adolescents requires further study; hopefully more enuretic children will receive adequate treatment before reaching adolescence.
评估青少年尿床者的特征，因为关于该年龄组遗尿症的数据较少。
在多位专家（儿科医生、泌尿科医生、妇科医生、精神科医生）的合作下创建了一个针对青少年和青年的特定数据库。问题集中在家族和个人病史、应激事件、实现排尿和排便控制的年龄、遗尿症的特征（原发性与继发性、单症状性与伴有日间排尿症状的遗尿症）、学业成绩、诊断检查和体格检查，以及治疗及其反应。
收集了107名遗尿青少年的数据（平均年龄15.3岁，中位数14岁，范围13 - 23岁；男性63名，女性44名）。82%的患者有遗尿症家族史阳性记录。79例患者（74%）为原发性遗尿，28例（26%）为继发性遗尿，76例（71%）为单症状性遗尿，31例（29%）伴有日间排尿症状。男性单症状性遗尿比女性显著更常见（P < 0.01）。13例患者报告有尿路感染，均为女性；6例存在饮食失调（厌食、多食）。85例患者（80%）的遗尿症被认为严重（≥每周三晚）。在107例患者中，27例（20%）从未就其问题咨询过医生，43例（40%）未接受过治疗；66例接受去氨加压素单药治疗，44例（79%）有良好反应（尿床夜数减半）。去氨加压素的反应与性别、年龄、遗尿症类型和严重程度或遗尿症家族史阳性无关。8例患者配备了夜间报警器，但2例无法耐受。总共25例患者拒绝任何治疗或不遵守给定的治疗。
遗尿症可持续到青少年期并成为一个重要问题；这些患者中80%有严重遗尿症，31%还伴有日间排尿症状，40%既往未接受过治疗。在这个年龄段，遗尿症的治疗可能特别困难；22%的患者对去氨加压素无反应，23%对给定治疗的依从性低。青少年遗尿症需要进一步研究；希望更多遗尿儿童在进入青春期前能得到充分治疗。
