Primary nocturnal enuresis: Assessment and treatment at a single referral center.
BACKGROUND
The aim of this study was to investigate the prevalence of primary monosymptomatic and non-monosymptomatic nocturnal enuresis (PMNE and PNMNE) and associated factors in a major referral center for NE in Abu Dhabi.


METHODS
Children referred to the Paediatric Continence Clinic, between 2014 and 2016, for PNE were included in the study. Exclusion criteria were neuropathic bladder, abnormality of the bladder and bowel, urethral stenosis, neurological and psychiatric problems, non-completion of the diagnostic protocol, and follow up <6 months.


RESULTS
A total of 128 patients were included in the study: 82 boys (64.1%) and 46 girls (35.9%). A total of 42.7% of boys and 8.7% of girls had PMNE, and 57.3% of boys and 91.3% of girls had PNMNE. Constipation was present in 46% of patients. In the male PNMNE group, 74.5% had overactive bladder (OAB), 10.6%, dysfunctional voiding (DV); and 14.9%, OAB + DV. In the female PNMNE group, 35.7% had OAB; 21.4%, DV; 40.5%, OAB + DV; and 2.4%, underactive bladder. A total of 97% and 86 of children with PMNE and PNMNE, respectively, had resolution of NE. Boys had a significantly higher incidence of PMNE, and girls, of DV.


CONCLUSION
In Abu Dhabi, NE is often associated with bladder dysfunction or DV, mostly in girls, and with constipation. High intake of dry, low fiber foods, along with hot weather and the stress of city living negatively affect the incidence of fecal retention and of NE. A multimodal approach, including the treatment of constipation, led to a satisfactory resolution of PNE in almost 90% of cases.
['Arena|Salvatore|S|http://orcid.org/0000-0003-0276-9211', 'Patricolo|Mario|M|']
D000293:Adolescent D002648:Child D002675:Child, Preschool D005260:Female D005500:Follow-Up Studies D006801:Humans D008297:Male D053206:Nocturnal Enuresis D015995:Prevalence D012017:Referral and Consultation D012189:Retrospective Studies D012307:Risk Factors D014479:United Arab Emirates
nocturnal enuresis constipation overactive bladder dysfunctional voiding