Kovacevic Larisa, Wolfe-Christensen Cortney, Mirkovic Jelena, Yih Jessica, Lakshmanan Yegappan
Department of Pediatric Urology, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, Michigan, 48201, USA,
Pediatr Nephrol. 2014 Jul;29(7):1189-94. doi: 10.1007/s00467-013-2742-y. Epub 2014 Jan 18.
Published guidelines regarding radiographic imaging in the evaluation of monosymptomatic primary nocturnal enuresis (MPNE) are not followed. We aimed to evaluate the prevalence of urological abnormalities on renal/bladder ultrasound (RBUS) in children with MPNE and to compare the RBUS findings in children with and without MPNE.
Retrospective data collection in all children aged 5-17 years seen for the initial evaluation of MPNE. Control group consisted of age- and sex-matched children who had abdominal ultrasound for other than bladder-/kidney-related causes. RBUS findings were analyzed with regard to the need for intervention and/or follow-up.
While abnormalities on RBUS were seen in 12.54% of enuretic children and in 5.38% of controls (p = 0.004), the majority of these findings were clinically insignificant. Of those with abnormalities, only 4 enuretic children (1.43%) required intervention and 8 (2.87%) needed follow-up studies. These rates were not significantly different from the controls. However, enuretic children with RBUS abnormalities appear to be more resistant to treatment than enuretic children with normal RBUS (p = 0.002).
A small proportion of abnormalities seen on RBUS in children with MPNE require intervention and/or further evaluation. The identification of insignificant RBUS findings could lead to unnecessary additional investigations owing to parental concern. Detailed history and a voiding diary may be sufficient in the initial evaluation of children with MPNE, although RBUS may play an important role in patients who are resistant to treatment.
关于单症状性原发性夜间遗尿症（MPNE）评估中放射影像学检查的已发表指南未得到遵循。我们旨在评估MPNE患儿肾/膀胱超声（RBUS）检查泌尿系统异常的患病率，并比较有和没有MPNE的儿童的RBUS检查结果。
对所有因MPNE初次就诊的5至17岁儿童进行回顾性数据收集。对照组由年龄和性别匹配、因膀胱/肾脏以外原因进行腹部超声检查的儿童组成。对RBUS检查结果进行分析，以确定是否需要干预和/或随访。
遗尿儿童中12.54%的RBUS检查存在异常，对照组中这一比例为5.38%（p = 0.004），但这些检查结果大多在临床上无显著意义。在有异常的患儿中，只有4名遗尿儿童（1.43%）需要干预，8名（2.87%）需要随访研究。这些比例与对照组无显著差异。然而，RBUS检查异常的遗尿儿童似乎比RBUS检查正常的遗尿儿童对治疗更具抵抗性（p = 0.002）。
MPNE患儿RBUS检查发现的一小部分异常需要干预和/或进一步评估。由于家长的担忧，识别出无显著意义的RBUS检查结果可能会导致不必要的额外检查。详细的病史和排尿日记在MPNE患儿的初始评估中可能就足够了，尽管RBUS检查在治疗抵抗的患者中可能发挥重要作用。
