Duration of treatment of primary enuresis with overactive bladder.

Characterizing the course of treatment of non-monosymptomatic enuresis with overactive bladder (OAB) in a real clinical setting.

Data from 111 OAB patients with moderate to severe enuresis were analyzed. Basic analysis included a questionnaire, a diary, a urine flow measurement with a postvoid residual urine measurement and a single abdominal x-ray of the kidneys, ureters and bladder (KUB). Following standard urotherapy for 1 month, an anticholinergic drug was administered with or without laxatives. Desmopressin was added if there was a partial response to OAB. Patients were followed every 3 months to assess the status of OAB and enuresis. Multivariate analysis was performed to identify predictors associated with the lack of complete response (CR) to enuresis at 12 months.

After 12 months of treatment, 64% and 88% of patients presented at least a partial response to enuresis and OAB. . The urgency has improved faster than enuresis, supporting the need to treat daytime symptoms before enuresis. Seventy-nine patients (71%) had fecal impaction on KUB and / or subjective constipation. The combination of anticholinergics and laxatives or desmopressin has withstood better than anticholinergics alone. Daytime incontinence and anticholinergic treatment alone were associated with a lack of CR for 12 months of treatment.

The data confirmed the validity of the treatment of overactive bladder before the treatment of enuresis. The results of this study also highlight the need to address faecal impaction. Patients should be informed of the need for prolonged treatment before starting treatment. Anticholinergics should be accompanied by desmopressin or laxatives for better control of enuresis

International neurourology journal. 2018 Jun 30 [Epub]

Young Jae Im, Jung Keun Lee, Kwanjin Park

Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.

PubMed http: //www.ncbi.nlm .nih.gov / pubmed / 29991232