The Effect of Adenotonsillectomy on Pediatric Nocturnal Enuresis: a Prospective Cohort Study

Document Type: Original

Authors

1 Department of Otolaryngology & Head and Neck surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

2 Department of Urology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

3 Research Center for Health Sciences , Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

Abstract

Introduction:
Sleep disorder caused by adenotonsillar hypertrophy has been implicated as a cause of primary and secondary nocturnal enuresis in children.  This study was conducted to investigate the effect of adenotonsillectomy on enuresis in children with adenotonsillar hypertrophy.
 Materials and Methods:
This prospective cohort study was conducted in Hamadan City in Western Iran, from April 2010 to December 2011. Ninety-seven children aged 3 to 12 years with adenotonsillar hypertrophy who were admitted to Besat Hospital for adenotonsillectomy were evaluated. The primary outcome was the number of incidents of bedwetting (nocturnal enuresis) post-operation compared with pre-operation. Patients were followed-up for 3 months. Data were collected using a questionnaire regarding number of bedwetting incidents, type of enuresis (primary or secondary), and family history of enuresis, as well as results of urine analysis.
 Results:
Of 420 children admitted for adenotonsillectomy, 97 had a positive history of preoperative enuresis, including 42 girls and 55 boys, with mean age of 48 months. The parents of 84 (86.6%) children agreed to participate in the study. Three months after adenotonsillectomy, enuresis had resolved completely in 51 (60.7%) children and had shown relative improvement in 22 (26.2%) children. Enuresis had not improved in the remaining 11 (13.1%) children (P<0.001).
 Conclusion: 
The results of this study indicate that adenotonsillectomy can improve enuresis in the majority of children with adenotonsillar hypertrophy. However, further evidence based on large multi-center randomized clinical trials is required to confirm these results.

Keywords


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