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Time Course of Treatment for Primary Enuresis With Overactive Bladder

PURPOSE: To characterize the course of treatment for nonmonosymptomatic enuresis with overactive bladder (OAB) in a real clinical setting. METHODS: Data from 111 OAB patients with moderate to severe enuresis were analyzed. The baseline analysis included a questionnaire, voiding diary, uroflowmetry w...

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Detalles Bibliográficos
Autores principales: Im, Young Jae, Lee, Jung Keun, Park, Kwanjin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Continence Society 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6059917/
https://www.ncbi.nlm.nih.gov/pubmed/29991232
http://dx.doi.org/10.5213/inj.1836020.010
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author Im, Young Jae
Lee, Jung Keun
Park, Kwanjin
author_facet Im, Young Jae
Lee, Jung Keun
Park, Kwanjin
author_sort Im, Young Jae
collection PubMed
description PURPOSE: To characterize the course of treatment for nonmonosymptomatic enuresis with overactive bladder (OAB) in a real clinical setting. METHODS: Data from 111 OAB patients with moderate to severe enuresis were analyzed. The baseline analysis included a questionnaire, voiding diary, uroflowmetry with postvoid residual urine measurement, and plain abdominal radiography of the kidneys, ureters, and bladder (KUB). Following standard urotherapy for 1 month, anticholinergic medication was administered with or without laxatives. Desmopressin was added if there was a partial response to OAB. Patients were followed every 3 months to evaluate the status of OAB and enuresis. Multivariate analysis was performed to identify predictors associated with the lack of complete response (CR) in enuresis at 12 months. RESULTS: Following 12 months of treatment, 64% and 88% of patients experienced at least partial response in enuresis and OAB, respectively. Urgency improved more quickly than enuresis, supporting the need to address daytime symptoms before enuresis. Seventy-nine patients (71%) had fecal impaction on KUB and/or subjective constipation. The combination of anticholinergics with either laxatives or desmopressin fared better than anticholinergics alone. Daytime incontinence and anticholinergics-only treatment were associated with a lack of CR during 12 months of treatment. CONCLUSIONS: The data confirmed the validity of addressing OAB before treating enuresis. The results of this study also highlight the need to address fecal impaction. Patients should be counseled about the need for a prolonged course of treatment before starting treatment. Anticholinergics should be accompanied with either desmopressin or laxatives for better control of enuresis.
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spelling pubmed-60599172018-07-27 Time Course of Treatment for Primary Enuresis With Overactive Bladder Im, Young Jae Lee, Jung Keun Park, Kwanjin Int Neurourol J Original Article PURPOSE: To characterize the course of treatment for nonmonosymptomatic enuresis with overactive bladder (OAB) in a real clinical setting. METHODS: Data from 111 OAB patients with moderate to severe enuresis were analyzed. The baseline analysis included a questionnaire, voiding diary, uroflowmetry with postvoid residual urine measurement, and plain abdominal radiography of the kidneys, ureters, and bladder (KUB). Following standard urotherapy for 1 month, anticholinergic medication was administered with or without laxatives. Desmopressin was added if there was a partial response to OAB. Patients were followed every 3 months to evaluate the status of OAB and enuresis. Multivariate analysis was performed to identify predictors associated with the lack of complete response (CR) in enuresis at 12 months. RESULTS: Following 12 months of treatment, 64% and 88% of patients experienced at least partial response in enuresis and OAB, respectively. Urgency improved more quickly than enuresis, supporting the need to address daytime symptoms before enuresis. Seventy-nine patients (71%) had fecal impaction on KUB and/or subjective constipation. The combination of anticholinergics with either laxatives or desmopressin fared better than anticholinergics alone. Daytime incontinence and anticholinergics-only treatment were associated with a lack of CR during 12 months of treatment. CONCLUSIONS: The data confirmed the validity of addressing OAB before treating enuresis. The results of this study also highlight the need to address fecal impaction. Patients should be counseled about the need for a prolonged course of treatment before starting treatment. Anticholinergics should be accompanied with either desmopressin or laxatives for better control of enuresis. Korean Continence Society 2018-06 2018-06-30 /pmc/articles/PMC6059917/ /pubmed/29991232 http://dx.doi.org/10.5213/inj.1836020.010 Text en Copyright © 2018 Korean Continence Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Im, Young Jae
Lee, Jung Keun
Park, Kwanjin
Time Course of Treatment for Primary Enuresis With Overactive Bladder
title Time Course of Treatment for Primary Enuresis With Overactive Bladder
title_full Time Course of Treatment for Primary Enuresis With Overactive Bladder
title_fullStr Time Course of Treatment for Primary Enuresis With Overactive Bladder
title_full_unstemmed Time Course of Treatment for Primary Enuresis With Overactive Bladder
title_short Time Course of Treatment for Primary Enuresis With Overactive Bladder
title_sort time course of treatment for primary enuresis with overactive bladder
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6059917/
https://www.ncbi.nlm.nih.gov/pubmed/29991232
http://dx.doi.org/10.5213/inj.1836020.010
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