Bladder-Urethra Rehabilitation Clinic, Yonsei University Health System, Korea.
Int J Urol. 2013 Aug;20(8):831-5. doi: 10.1111/iju.12054. Epub 2013 Jan 8.
Previous reports have suggested that the incidence of spina bifida occulta in patients with nocturnal enuresis is higher than in the general population. However, the effect of spina bifida occulta on the response to nocturnal enuresis treatment is controversial. The purpose of this study was to investigate the relationship between spina bifida occulta and response to treatment of nocturnal enuresis.
Between 2006 and 2009, the records of 160 children with nocturnal enuresis were reviewed. Children with other organic urological disease or symptoms suggestive of spinal dysraphism were excluded. Plain radiography for the kidney-ureter-bladder was carried out before the start of the nocturnal enuresis treatment. Response to treatment of children with and without spina bifida occulta was compared.
Of 160 children, 53 were girls; the mean age was 7.8 ± 2.06 years. The mean duration of treatment was 8.7 ± 9.29 months. Spina bifida occulta was detected in 43 children (26.9%). Spina bifida occulta affected L4 in four children, L5 in 12 children, S1 in 26 children and S2 in one child. There was a significant difference between the spina bifida occulta and non-spina bifida occulta groups in terms of outcome (P=0.002), with a complete response more likely in children without spina bifida occulta (P=0.005). None of the children with primary non-mono symptomatic nocturnal enuresis and spina bifida occulta showed a complete response.
The presence of spina bifida occulta significantly affects the response to treatment in patients with nocturnal enuresis. Thus, verifying spina bifida occulta in this patient population can facilitate the prediction of the response to nocturnal enuresis treatment.
先前的报告表明，隐性脊柱裂患者夜间遗尿的发病率高于普通人群。然而，隐性脊柱裂对夜间遗尿治疗反应的影响存在争议。本研究旨在探讨隐性脊柱裂与夜间遗尿治疗反应之间的关系。
回顾 2006 年至 2009 年间 160 例夜间遗尿症患儿的病历资料。排除其他器质性泌尿外科疾病或有脊柱裂畸形症状的患儿。在开始夜间遗尿症治疗前，对患儿进行肾脏-输尿管-膀胱的平片检查。比较有和无隐性脊柱裂患儿的治疗反应。
160 例患儿中，女孩 53 例，平均年龄为 7.8±2.06 岁。平均治疗时间为 8.7±9.29 个月。43 例患儿（26.9%）检测出隐性脊柱裂。隐性脊柱裂影响 L4 的患儿 4 例，L5 的患儿 12 例，S1 的患儿 26 例，S2 的患儿 1 例。隐性脊柱裂组与非隐性脊柱裂组的治疗结果存在显著差异（P=0.002），无隐性脊柱裂的患儿更可能完全缓解（P=0.005）。原发性非单症状性夜间遗尿症且伴隐性脊柱裂的患儿无一例完全缓解。
隐性脊柱裂的存在显著影响夜间遗尿症患者的治疗反应。因此，在该患者人群中验证隐性脊柱裂有助于预测夜间遗尿症的治疗反应。
