Sousa Ariane Sampaio, Veiga Maria Luisa, Braga Ana Aparecida N, Carvalho Maria Clara, Barroso Ubirajara
Escola Bahia de Medicina e Saúde Pública - Pos - Graduação, Salvador, Brasil.
Departamento Urologia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brasil.
Int Braz J Urol. 2016 Jul-Aug;42(4):798-802. doi: 10.1590/S1677-5538.IBJU.2015.0579.
Evaluate clinical aspects associated with the presence of nocturnal enuresis (NE) in children with a diagnosis of overactive bladder (OAB).
A data base of 200 children who were evaluated by a structured questionnaire was analysed retrospectively . OAB was defined as the presence of urinary urgency (n=183 cases) and/or daytime urinary incontinence associated with holding maneuvers (n=168 cases). Inclusion criteria were a confirmed diagnosis of OAB, age 5-16 years, and no anatomical or neurological alterations of the urinary tract. Patients were divided into enuretics and non-enuretics. The two groups were compared with respect to sex, age, skin color, presence urinary infection, urgency, urge incontinence, non-urge incontinence, pollakiuria, urinary dysfunction, nocturia, holding maneuvers, number of episodes of enuresis and bowel alterations. In a univariate analysis, the chi-square test was used to compare proportions, with p-values <0.05 being considered significant. A multivariate analysis was conducted to identify independent predictive factors.
Enuresis was diagnosed in 141/200 children. The two groups were similar with respect to sex, age and skin color. No difference was found in relation to urinary infection, non-urge incontinence, urinary dysfunction, nocturia, encopresis or constipation. The two groups were significantly different with regard to some symptoms related to OAB such as urgency (p=0.001), urge incontinency (p=0.001) and holding maneuvers (p=0.033). Following multivariate analysis, only holding maneuvers (p=0.022) remained as an independent predictive factor.
The only independent predictive factor for resolution of enuresis in children with OAB, as detected in the multivariate analysis, was holding maneuvers.
评估诊断为膀胱过度活动症（OAB）的儿童夜间遗尿（NE）的相关临床情况。
回顾性分析通过结构化问卷评估的200名儿童的数据库。OAB定义为存在尿急（n = 183例）和/或与憋尿动作相关的日间尿失禁（n = 168例）。纳入标准为确诊OAB、年龄5 - 16岁且无尿路解剖或神经学改变。患者分为遗尿组和非遗尿组。比较两组在性别、年龄、肤色、是否存在泌尿系统感染、尿急、急迫性尿失禁、非急迫性尿失禁、尿频、排尿功能障碍、夜尿、憋尿动作、遗尿发作次数和肠道改变方面的情况。在单因素分析中，采用卡方检验比较比例，p值<0.05被认为具有统计学意义。进行多因素分析以确定独立预测因素。
200名儿童中有141名被诊断为遗尿。两组在性别、年龄和肤色方面相似。在泌尿系统感染、非急迫性尿失禁、排尿功能障碍、夜尿、大便失禁或便秘方面未发现差异。两组在一些与OAB相关的症状如尿急（p = 0.001）、急迫性尿失禁（p = 0.001）和憋尿动作（p = 0.033）方面存在显著差异。多因素分析后，仅憋尿动作（p = 0.022）作为独立预测因素保留。
多因素分析检测到，OAB儿童遗尿缓解的唯一独立预测因素是憋尿动作。
