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Spina bifida occulta: Not to be overlooked in children with nocturnal enuresis

 Sang Hee Shin  ;  Young Jae Im  ;  Mi-Jung Lee  ;  Yong Seung Lee  ;  Eun Kyoung Choi  ;  Sang Won Han 
 INTERNATIONAL JOURNAL OF UROLOGY, Vol.20(8) : 831-835, 2013 
Journal Title
Issue Date
Adolescent ; Antidiuretic Agents/therapeutic use ; Child ; Child, Preschool ; Cholinergic Antagonists/therapeutic use ; Deamino Arginine Vasopressin/therapeutic use* ; Female ; Humans ; Incidence ; Male ; Nocturnal Enuresis/drug therapy* ; Nocturnal Enuresis/epidemiology* ; Predictive Value of Tests ; Radiography ; Retrospective Studies ; Spina Bifida Occulta/diagnostic imaging ; Spina Bifida Occulta/epidemiology* ; Treatment Outcome
X-ray film ; anticholinergics ; desmopressin ;  nocturnal enuresis ;  spina bifida occulta
OBJECTIVE: Previous reports have suggested that the incidence of spina bifida occulta in patients with nocturnal enuresis is higher than in the general population. However, the effect of spina bifida occulta on the response to nocturnal enuresis treatment is controversial. The purpose of this study was to investigate the relationship between spina bifida occulta and response to treatment of nocturnal enuresis. METHODS: Between 2006 and 2009, the records of 160 children with nocturnal enuresis were reviewed. Children with other organic urological disease or symptoms suggestive of spinal dysraphism were excluded. Plain radiography for the kidney-ureter-bladder was carried out before the start of the nocturnal enuresis treatment. Response to treatment of children with and without spina bifida occulta was compared. RESULTS: Of 160 children, 53 were girls; the mean age was 7.8 ± 2.06 years. The mean duration of treatment was 8.7 ± 9.29 months. Spina bifida occulta was detected in 43 children (26.9%). Spina bifida occulta affected L4 in four children, L5 in 12 children, S1 in 26 children and S2 in one child. There was a significant difference between the spina bifida occulta and non-spina bifida occulta groups in terms of outcome (P=0.002), with a complete response more likely in children without spina bifida occulta (P=0.005). None of the children with primary non-mono symptomatic nocturnal enuresis and spina bifida occulta showed a complete response. CONCLUSIONS: The presence of spina bifida occulta significantly affects the response to treatment in patients with nocturnal enuresis. Thus, verifying spina bifida occulta in this patient population can facilitate the prediction of the response to nocturnal enuresis treatment.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
Lee, Yong Seung(이용승) ORCID logo https://orcid.org/0000-0003-3778-9888
Im, Young Jae(임영재)
Choi, Eun Kyoung(최은경) ORCID logo https://orcid.org/0000-0003-4622-2437
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
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