-

Öz

INTRODUCTION: Monosymptomatic enuresis nocturia (MEN) is characterized urinary incontinence without frequent urination, urge and urge incontinence during day. The social and psychological problems can be arise on both children and their family due to enuresis, mothers taking care of these children can become restless, lonely and helpless; by time. We aimed to compare the life qualities of both children and their mother before and after the treatment. METHODS: Forty-seven children diagnosed as MEN, aged between 6-18 years were included into the study. Desmopressin was given after diagnosis. Life Quality Scale for Children (LQSC) and SF-36 form for mothers were practiced before treatment and on 3rd months of treatment. Health activity scores, emotional score, interrelations with others and school problem scores were evaluated by LQSC before and after treatment in children. SF-36 forms practiced on mothers had total 8 scales; consisting of physical functional score, ache assessment, physical play difficulty, social functions, viability, mental health, emotional status and general health. RESULTS: The mean age of children were 11.6 ± 2.3 years and 24 ( 51.1% ) of them were male and 23 (48.9 % ) of them were girl. For the children all scales of LQSC before treatment were markedly low, and after treatment all increased to statistically significant level (P<0.01). Similarly, all 8 scales for mothers were also markedly increased after treatment (P<0.01). CONCLUSION:Enuresis significantly affects the life quality of both children and mothers. Treatment of enuresis with suitable methods and regular follow up improve life quality of patients and their family by markedly decreasing of their stress condition

Anahtar Kelimeler

• enuresis, life quality

MONOSEMPTOMATİK ENUREZİSLİ ÇOCUKLARDA VE ANNELERİNDE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ

Öz

Enürezis , doğuştan ya da kazanılmış MSS defekti olmayan 5 yaşın üzerindeki çocuklarda, gece uyurken aralıklarla oluşan  idrar kaçırma davranışıdır (1). Enurezis, monosemptomatik ve polisemptomatik olarak 2 gruba ayrılır. Monosemptomatik  enürezis noktürna (MEN),  sık idrara çıkma, acil sıkışma hissi, gündüz inkontinans gibi gündüz işeme semptomlarının olmamasıyla karakterizedir. Beş yaş üzerine MEN görülme sıklığının % 20-30 olup 15 yaşında %1 ‘e kadar azaldığı bildirilmiştir (2,3,4).

Etyolojide ailesel yatkınlık, uyku bozukluğu, hormonal etkenler, gelişimsel sorunlar, mesane fonksiyonları ve psikososyal etkenler üzerinde durulmuştur (5,6). Tedavide davranış tedavisi, alarm tedavisi, farmakolojik ya da kombine tedaviler uygulanmaktadır (7,8). Enurezis sebebiyle çocuklarda ve ailelerinde psikolojik ve sosyal sorunlar ortaya çıkabilmektedir (9). Enürezisli çocukların bu durumdan utandıkları, mutsuz ve huzursuz olup birtakım davranış problemleri sergiledikleri bildirilmiştir (10,11,12). Enürezisli çocuğun bakımıyla uğraşan annelerde ise zamanla çaresizlik, yalnızlık ve bıkkınlık oluşmakta, sosyal yaşamlarında ve kendilerine ayırdıkları zamanda kısıtlılık yaşamaları sonucu yaşam kaliteleri bozulmakta ve psikiyatrik belirtiler ortaya çıkmaktadır (13,14).

Bu çalışmanın amacı MEN tanısı almış çocuklar ile annelerinin tedavi öncesi ve tedavi  sonrası yaşam kalitelerini karşılaştırmaktır.

Anahtar Kelimeler

• Enürezis

Kaynakça

1. Neveus T, Von Gontard A, Hoebeke P, Hjalmas K. The standardisation of terminology of lower urinary tract functional in children and adolescent. Report from the standardisation comittee of the international children’s continence society (ICSS) J Urol 2006;176:314-24.
2. Kuehhas FE, Djakovic N, Hohenfellner M. Infantile enuresis: current state-of-the-art therapy and future trends. Rev Urol 2011;13(1):1–5
3. Yazici CM, Nalbantoglu B, Topcu B, Dogan C. Prevalence of nocturnal enuresis and associated factors in schoolchildren in Western Turkey. Can J Urol 2012 Aug; 19(4):6383-8.
4. Ozden C, Ozdal OL, Altinova S, Oguzulgen I, Urgancioglu G, Memis A. Prevalence and associated factors of enuresis in Turkish children. Int Braz J Urol 2007;33(2):216-22.
5. Nevéus T. Nocturnal enuresis—theoretic background and practical guidelines. Pediatr Nephrol. 2011;26:1207–14.
6. Ramamurthy HR, Kanitkar M. Non invasive urodynamic assessment in children—are they reliable? Validation of non-invasive urodynamics in children with functional voiding disorders. Indian J Pediatr 2010;77:1400–4
7. Abrams P, Cardozo L, Fall M, et al. The standardization of terminology of lower urinary tract function: report from the standardization Subcommitee of the International Continence Society. Nurourol Urodyn 2002;21:167-8.
8. Tekgül S. Enürezis nokturnaya ürolojik bir bakış açısı. Katkı Pediatri Dergisi 1998;19(1):50-8

9. Bastiaansen D, Koot HM, Ferdinand RF, Verhulst FC: Quality of life in children with psychiatric disorders: self-, parent, and clinician report. J Am Acad Child Adolesc Psychiatry 2004; 43: 221.
10. Assiri F, Al-Yousif A, Al-Mahmoud N. Nocturnal enuresis among children attending Kifan primary health care center in Kuwait. Alexandria Bulletin.2007;43:879–
11. M. J.Morison. Living with a young person who wets the bed: the families experience. British Journal of Nursing 2000;9:572–78.
12. Hägglöf B, Andren O, Bergström E, Marklund L, Wendelius M: Self-esteem in children with nocturnal enuresis and urinary incontinence: improvement of self- esteem after treatment. Eur Urol 1998; 33: 16.
13. Egemen A, Akil I, Canda E, Ozyurt BC, Eser E. An evaluation of quality of life of mothers of children with enuresis nocturna. Pediatr Nephrol 2008;23:93-8.
14. Butler RJ, Brewin CR, Forsythe WI. Maternal attributions and tolerance for nocturnal enuresis. Behav Res Ther 1986;24(3):307-12.
15. Hagglof B, Andren O, Bergstrom E, Marklund L, Wendelius M. Self-esteem before and after treatment in children with nocturnal enuresis and urinary incontinence. Scand J Urol Nephrol 1997;31:79–82
16. Liu X, Sun Z, Uchiyama M, Li Y, Okawa M. Attaining nocturnal urinary control, nocturnal enuresis and behavioral problems in Chinese children, aged 6 through 16 years. J Am Acad Child Adolesc Psychiatry 2000;39:1557–64
17. OL WHOQ .Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL group. Psychol Med1998; 3:551–58
18. Lv R, Wu L, Jin L et al: Depression, anxiety and quality of life in parents of children with epilepsy. Acta Neurol Scand 2009; 120: 335-41.
19. Klassen AF, Klaassen R, Dix D et al: Impact of caring for a child with cancer on parents’ health-related quality of life. J Clin Oncol 2008; 26: 5884-89.
20. Memik NÇ, Ağaoğlu B, Coşkun A, Karakaya I. The Validity and Reliability Of Pediatric Quality Of Life Inventory In 8- 12 Year Old Turkish Children. Turkish Journal of Child and Adolescent Mental Health 2008; 87
21. Görgel SC, Köse O, Dincel N, Girgin C. Should we treat monosymptomatic enuresis in children? Yeni Üroloji Dergisi - The New Journal of Urology 2013; 8 (3): 19-24
22. Ucer O, Gumus B. Quantifying subjective assessment of sleep quality, quality of life and depressed mood in children with enuresis. World J Urol 2014 32:239–43.
23. Ware JE Jr, Sherbourne CD. TheMOS 36-item Short- Form Health Survey (SF-36) I. Conceptual framework and item selection. Med Care 1992;30:473-83.
24. Meydan EA, Civilibal M, Elevli M, Duru NS, Civilibal N. The quality of life of mothers of children with monosymptomatic enuresis nocturna. Int Urol Nephrol 2012;44:655–59.
25. Naitoh Y, Kawauchi A, Soh J, Kamoi K, Miki T. Health Related Quality of Life for Monosymptomatic Enuretic Children and Their Mothers. he Journal of Urology, November 2012;5,1910-1914.