August 2016 Vol. 4 No.8

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Original Research Article

Urodynamic findings in patient above 15 years old with primary refractory nocturnal enuresis

Dr. Mohammed Bassil Ismail

Urosurgeon, CABMS (Urology) Urology Department, Medical City Complex, Baghdad, Iraq.

E-mail: mohammed_albassil@yahoo.com

Accepted August 08, 2016

Abstract

Enuresis is normal but involuntary voiding that occurs at an inappropriate time or social setting, during the day, night, or both. Nocturnal enuresis describes any involuntary loss of urine during sleep. It is classified into:- 1) Primary: never been dry for more than 6-month period. 2) Secondary: re-emergence of bed wetting after a period of being dry for at least 6 months. This study included 35 patients older than 15 years with primary refractory enuresis; 24 males and 11 females. All had tried multiple courses of medical treatment for enuresis without response for at least six months. All patients underwent full urodynamic investigation by cystometry, profilometry, uroflowmetry and electromyogram. After failure of medical and behavioral therapy in enuresis, the usual next step is to investigate using urodynamics. The aim of this study was to find the urodynamic finding in enuretic patients above 15 years of age so that we can determine the actual benefit of urodynamics in the treatment of refractory enuresis. All 35 patients have one or more urodynamic abnormality; 11 patient have Detrusor‒ sphincterdyssynergia (DSD) (31.43%(,15 Patient have bladder overactivity (42.86( %,16 patient has high postvoid (45.71%), 20 patient have high urethral pressure profile (57.10%), 4 patient have low urethral pressure profile 11 (40%), 29 patient have small capacity bladder (82.86%), 6 patient have large bladder capacity (17.14(%, 28 patient have low average flow rate (80%), 21 patient have hypocomplinet bladder (60%). Urodynamics is very helpful in cases of refractory enuresis by detecting voiding dysfunction which is present in all of these patients.

Keywords: Bladder capacity, Detrusor‒sphincterdyssynergia, Flow rate, Refractory enuresis, Urodynamics