Department of Child & Adolescent Psychiatry, Wuhan Mental Health Center (Wuhan Hospital for Psychotherapy), 430012 Wuhan, Hubei, China.
Department of Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430023 Wuhan, Hubei, China.
Arch Esp Urol. 2023 Sep;76(7):525-531. doi: 10.56434/j.arch.esp.urol.20237607.65.
This study aimed to investigate the effect of multidisciplinary assessment in paediatric patients with monosymptomatic nocturnal enuresis (MNE).
From July 2018 to June 2021, 242 patients with enuresis who received diagnosis and treatment in our hospital were retrospectively enrolled. They were divided into the multidisciplinary assessment group (n = 130) and routine assessment group (n = 112). Multidisciplinary assessments were completed by a multidisciplinary team, and the data included structured medical history, physical and neurological examinations, bladder and bowel diaries, sleep diaries, questionnaires, psychological assessments, urinary ultrasonography, blood and urine laboratory tests, polysomnography and balance assessments.
A higher proportion of patients with enuresis associated with other conditions was identified in the multidisciplinary assessment group than in the routine assessment group (27.7% vs 15.2%, = 0.019). With regard to treatment response to the enuresis alarm, the treatment response rate was 52.9% (17/33) in the conventional assessment group, whereas such a response was significantly higher in the multidisciplinary assessment group (82.1%, 32/39; = 0.028). Compared with the routine assessment group, the multidisciplinary assessment group had a significantly higher treatment response rate for desmopressin (83.3% vs 52.0%; = 0.022) and alarms combined with desmopressin (74.2% vs 44.4%; = 0.045). After treatment, the Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0) score in the multidisciplinary assessment group was significantly higher than that in the routine assessment group (91.9 ± 6.3 vs 87.1 ± 7.3; < 0.001).
Multidisciplinary evaluation can identify more children with enuresis caused by other diseases, which promotes the differential diagnosis of MNE. In addition, multidisciplinary assessment can determine the appropriate treatment response in children with MNE.
本研究旨在探讨多学科评估对单症状性夜间遗尿症（MNE）患儿的影响。
回顾性纳入 2018 年 7 月至 2021 年 6 月在我院接受诊断和治疗的 242 例遗尿症患者，将其分为多学科评估组（n=130）和常规评估组（n=112）。多学科评估由多学科团队完成，数据包括结构化病史、体格和神经系统检查、膀胱和肠道日记、睡眠日记、问卷、心理评估、超声检查、血液和尿液实验室检查、多导睡眠图和平衡评估。
多学科评估组遗尿症伴发其他疾病的患者比例高于常规评估组（27.7% vs 15.2%， = 0.019）。遗尿报警器治疗反应方面，常规评估组的治疗反应率为 52.9%（17/33），而多学科评估组的治疗反应率显著更高（82.1%，32/39； = 0.028）。与常规评估组相比，多学科评估组去氨加压素（83.3% vs 52.0%； = 0.022）和报警器联合去氨加压素（74.2% vs 44.4%； = 0.045）的治疗反应率显著更高。治疗后，多学科评估组儿童生活质量量表 4.0 版（PedsQL 4.0）评分明显高于常规评估组（91.9±6.3 vs 87.1±7.3； < 0.001）。
多学科评估可发现更多由其他疾病引起的遗尿症患儿，有助于 MNE 的鉴别诊断。此外，多学科评估还可以确定 MNE 患儿的适当治疗反应。
