Firoozi Farzeen, Batniji Rami, Aslan Ahmet R, Longhurst Penelope A, Kogan Barry A
Division of Urology, Albany Medical College, Albany, New York 12208-3499, USA.
J Urol. 2006 May;175(5):1885-8; discussion 1888. doi: 10.1016/S0022-5347(05)00935-3.
Adenotonsillar hyperplasia causes upper airway obstruction, leading to obstructive sleep apnea. We reviewed the incidence of nocturnal enuresis in a population of children with adenotonsillar hyperplasia. In addition, we investigated the rate of resolution or improvement in enuresis following surgery for relief of adenotonsillar hyperplasia.
We studied 86 consecutive prepubertal children, 46 boys and 40 girls, who underwent adenotonsillectomy. Severity of adenotonsillar obstruction was graded on a scale of 1 to 4. A questionnaire regarding voiding problems, including nocturnal enuresis, voids per day and daytime enuresis episodes, was filled out preoperatively and postoperatively by the patients and their parents.
Among the 86 patients who underwent adenotonsillectomy 36 (42%) had nocturnal enuresis. In patients with nocturnal enuresis the number of episodes was significantly less after adenotonsillectomy. Overall, 12 patients (33%) had complete resolution, 11 (31%) had significant improvement and 13 (36%) showed no change. In addition, we noted a significant decrease in daytime enuresis episodes and voids per day.
Children with upper airway obstruction have a high rate of nocturnal enuresis that improves at twice the anticipated rate after treatment of the airway obstruction. In addition, we observed that daytime voiding dysfunction improves in these patients.
腺样体扁桃体增生会导致上呼吸道阻塞,进而引发阻塞性睡眠呼吸暂停。我们回顾了腺样体扁桃体增生患儿群体中夜间遗尿的发生率。此外,我们还研究了腺样体扁桃体增生手术后遗尿症状缓解、改善或消失的比例。
我们对86例青春期前连续接受腺样体扁桃体切除术的患儿进行了研究,其中46例为男孩,40例为女孩。腺样体扁桃体阻塞的严重程度按1至4级进行分级。术前和术后,患者及其父母需填写一份关于排尿问题的问卷,包括夜间遗尿、每日排尿次数和日间遗尿发作情况。
在接受腺样体扁桃体切除术的86例患者中,36例(42%)有夜间遗尿症状。对于有夜间遗尿症状的患者,腺样体扁桃体切除术后发作次数显著减少。总体而言,12例患者(33%)遗尿症状完全消失,11例(31%)有显著改善,13例(36%)无变化。此外,我们还注意到日间遗尿发作次数和每日排尿次数显著减少。
上呼吸道阻塞的儿童夜间遗尿发生率较高,在气道阻塞得到治疗后,遗尿症状改善的速度是预期速度的两倍。此外,我们观察到这些患者的日间排尿功能障碍也有所改善。