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Üst solunum yolu obstrüktif patolojiler ile primer nokturnal enürezis arasındaki ilişkinin değerlendirilmesi

Year 2019, Volume: 16 Issue: 2, 316 - 320, 29.08.2019
https://doi.org/10.35440/hutfd.579992

Abstract

Amaç: Bu
çalışmada alerjik rinit (AR), nazal septum deviasyonu (NSD), adenoid
hipertrofisi (AH) ve tonsiller hipertrofi (TH) gibi üst solunum yolu obstrüktif
patolojiler ile primer nokturnal enurezis (PNE) arasındaki ilişkinin ortaya
konulması amaçlandı.

Materyal ve Metot:
Çalışmaya 1 Haziran 2018- 1 Eylül 2018 tarihleri arasında ikinci basamak bir
hastanenin Pediatri ve Üroloji polikliniklerine başvuran ve gönüllü olan 78 PNE
hastası (42 erkek, 36 kız; ort. yaş: 7.2±1.6, dağılım: 5.4 - 11.6 yıl) dahil
edildi. Kontrol grubuna ise aynı hastanenin sağlam çocuk polikliniklerine
başvuran ve PNE şikayeti olmayan 5 yaş üstü 72 gönüllü çocuk ( 34 erkek, 38
kız; ort. yaş: 7.6±1.4 yıl, dağılım: 5.1 - 12.7 yıl ) dahil edildi. Çalışmaya
alınan tüm katılımcılara rutin fizik muayene, fleksibl fiberoptik
nazofarengoskopi ve alerjik rinit için skor (Score for allergic rhinitis; SFAR)
anketi uygulandı. Tonsil ve adenoid boyutlarını sınıflandırmak için sırasıyla
Brodsky skalası ve fiberendoskopik bulgular kullanıldı.

Bulgular: Yaş ve
cinsiyet açısından PNE (+) grup ile PNE (-) grup arasında anlamlı bir fark
yoktu (sırasıyla p= 0.203 ve p= 0.819). Alerjik rinit ve NSD her iki grupta
benzer olmasına karşın AH ve TH oranı PNE (+) grupta istatistiksel olarak
anlamlı bir şekilde daha fazla idi (sırasıyla p=0.016 ve p= 0.05).







Sonuç: Primer
nokturnal enürezisli çocuklarda adenotonsiller hipertrofi mutlaka akla
getirilmelidir.

Amaç: Bu
çalışmada alerjik rinit (AR), nazal septum deviasyonu (NSD), adenoid
hipertrofisi (AH) ve tonsiller hipertrofi (TH) gibi üst solunum yolu obstrüktif
patolojiler ile primer nokturnal enurezis (PNE) arasındaki ilişkinin ortaya
konulması amaçlandı.


Materyal ve Metot:
Çalışmaya 1 Haziran 2018- 1 Eylül 2018 tarihleri arasında ikinci basamak bir
hastanenin Pediatri ve Üroloji polikliniklerine başvuran ve gönüllü olan 78 PNE
hastası (42 erkek, 36 kız; ort. yaş: 7.2±1.6, dağılım: 5.4 - 11.6 yıl) dahil
edildi. Kontrol grubuna ise aynı hastanenin sağlam çocuk polikliniklerine
başvuran ve PNE şikayeti olmayan 5 yaş üstü 72 gönüllü çocuk ( 34 erkek, 38
kız; ort. yaş: 7.6±1.4 yıl, dağılım: 5.1 - 12.7 yıl ) dahil edildi. Çalışmaya
alınan tüm katılımcılara rutin fizik muayene, fleksibl fiberoptik
nazofarengoskopi ve alerjik rinit için skor (Score for allergic rhinitis; SFAR)
anketi uygulandı. Tonsil ve adenoid boyutlarını sınıflandırmak için sırasıyla
Brodsky skalası ve fiberendoskopik bulgular kullanıldı.



Bulgular: Yaş ve
cinsiyet açısından PNE (+) grup ile PNE (-) grup arasında anlamlı bir fark
yoktu (sırasıyla p= 0.203 ve p= 0.819). Alerjik rinit ve NSD her iki grupta
benzer olmasına karşın AH ve TH oranı PNE (+) grupta istatistiksel olarak
anlamlı bir şekilde daha fazla idi (sırasıyla p=0.016 ve p= 0.05).



Sonuç: Primer
nokturnal enürezisli çocuklarda adenotonsiller hipertrofi mutlaka akla
getirilmelidir.

References

  • 1 Norgaard JP, van Gool JD, Hjalmas K, Djurhuus JC and Hellstrom AL. Standardization and definitions in lower urinary tract dysfunction in children. International Children's Continence Society. Br J Urol May 1998;81:1-16.
  • 2 Choudhary B, Patil R, Bhatt GC, Pakhare AP, Goyal A, P A, Dhingra B, Tamaria KC.Association of Sleep Disordered Breathing with Mono-Symptomatic Nocturnal Enuresis: A Study among School Children of Central India.PLoS One. 2016 May 18;11(5):e0155808.
  • 3 Ou Anyanwu,Rc Ibekwe And Ml Orjı. Nocturnal Enuresis Among Nigerian Children And Its Association With Sleep, Behavior And School Performance Indian Pediatrics Volume 52_July15, 2015 P:587-589.
  • 4 Strömgren A, Thomsen PH.Personality traits in young adults with a history of conditioning-treated childhood enuresis. Acta Psychiatr Scand. 1990 Jun;81(6):538-41.5 Aydın S, Sanli A, Celebi O, Tasdemir O, Paksoy M, Eken M, Hardal U, Ayduran E. Prevalence of adenoid hypertrophy and nocturnal enuresis in primary school children in Istanbul, Turkey.Int J Pediatr Otorhinolaryngol. 2008 May;72(5):665-8.
  • 6 Muhsin Balaban , Alper Aktas , Cuneyd Sevinc, Ugur Yucetas. The relationship of enuresis nocturna and adenoid hypertrophy.Archivio Italiano di Urologia e Andrologia 2016; 88, 2.
  • 7 Karakas HB, Mazlumoglu MR, Simsek E. The role of upper airway obstruction and snoring in the etiology of monosymptomatic nocturnal enuresis in children. Eur Arch Otorhinolaryngol. 2017 Jul;274(7):2959-2963.
  • 8 Annesi-Maesano I, Didier A, Klossek M, Chanal I, Moreau D, Bousquet J. The score for allergic rhinitis (SFAR): a simple and valid assessment method in population studies. Allergy 2002; 57: 107-14.
  • 9 Cingi C, Songu M, Ural A, Annesi-Maesano I, Erdogmus N, Bal C, et al. The Score For Allergic Rhinitis study in Turkey. Am J Rhinol Allergy 2011;25:333-7.
  • 10 L. Brodsky, L. Moore, J.F. Stanievich, A comparison of tonsillar size and oropharyngeal dimensions in children with obstructive adenotonsillar hypertrophy, Int. J. Pediatr. Otorhinolaryngol; 1987: 13: 149–56.
  • 11 B. J. Sadock and V. A. Sadock, Kaplan and Sadocks Comprehensive Textbook of Psychiatry, vol. 2, Lippincott Williams &Wilkins, Philadelphia, Pa, USA, 2000.
  • 12 Müferret Ergüven, Yalçın Çelik, Murat Deveci, Nurdan Yıldız Etiological risk factors in primary nocturnal enuresis. Türk Pediatri Arşivi 2004; 39: 83- 7.
  • 13 Migueis DP, Thuler LC, Lemes LN, Moreira CS, Joffily L, Araujo-Melo MH. Systematic review: the influence of nasal obstruction on sleep apnea. Braz J Otorhinolaryngol. 2016 Mar-Apr;82(2):223-31.
  • 14 R.M. Bland, S. Bulgarelli, J.C. Ventham, D. Jackson, J.J. Reilly, J.Y. Paton, Total energy expenditure in children with obstructive sleep apnoea syndrome, Eur. Respir. J. 2001:18 164–9.
  • 15 Kovacevic L, Wolfe-Christensen C, Lu H, Toton M, Mirkovic J, Thottam PJ, Abdulhamid I, Madgy D, Lakshmanan Y.Why Does adenotonsillectomy not correct enuresis in all children with sleep disordered breathing?. J Urol. 2014 May;191(5 Suppl):1592-6.
  • 16 Weider DJ. ve arkWeider DJ, Sateia MJ, West RP. Nocturnal enuresis in children with upper airway obstruction. Otolaryngol Head Neck Surg. 1991 Sep;105(3):427-32.
  • 17 Tsai JD, Chen HJ, Ku MS, Chen SM, Hsu CC, Tung MC, Lin CC, Chang HY, Sheu JN. Association between allergic disease, sleep-disordered breathing, and childhood nocturnal enuresis: a population-based case-control study. Pediatr Nephrol. 2017 Dec;32(12):2293-2301.

Evaluation of the relationship between upper airway obstruction and primary nocturnal enuresis

Year 2019, Volume: 16 Issue: 2, 316 - 320, 29.08.2019
https://doi.org/10.35440/hutfd.579992

Abstract

Background:
The aim of this study was to determine the relationship between primary
nocturnal enuresis (PNE) and upper airway obstructive pathologies such as
allergic rhinitis (AR), nasal septum deviation (NSD), adenoid hypertrophy (AD)
and tonsillar hypertrophy (TH).

Methods: The study included
78 volunteer PNE patients (42 males, 36 females; mean age: 7.2 ± 1.6 years,
range: 5.4 to 11.6 years) who applied to Pediatrics and Urology outpatient
clinics of a second-stage hospital between June 1, 2018 and September 1, 2018.
The control group included 72 volunteer children (34 males, 38 females; mean
age: 7.6 ± 1.4 years, range: 5.1 to 12.7 years) who were admitted to the
inpatient outpatient clinics of the same hospital and had no PNE complaint. All
participants included in the study were applied routine physical examination,
flexible fiberoptic nasopharyngoscopy and score for allergic rhinitis (SFAR)
questionnaire. Brodsky scale and fiberendoscopic findings were used to classify
tonsil and adenoid dimensions respectively.

Results: There was no
significant difference between PNE (+) and PNE (-) groups in terms of age and
gender (respectively p = 0.203 and p = 0.819). Although AR and NSD were similar
in both groups, the ratio of AH and TH was statistically significantly higher
in the PNE (+) group (p = 0.016 and p = 0.05, respectively).







Conclusion:
Adenotonsillar hypertrophy must be considered in children with primary
nocturnal enuresis.

References

  • 1 Norgaard JP, van Gool JD, Hjalmas K, Djurhuus JC and Hellstrom AL. Standardization and definitions in lower urinary tract dysfunction in children. International Children's Continence Society. Br J Urol May 1998;81:1-16.
  • 2 Choudhary B, Patil R, Bhatt GC, Pakhare AP, Goyal A, P A, Dhingra B, Tamaria KC.Association of Sleep Disordered Breathing with Mono-Symptomatic Nocturnal Enuresis: A Study among School Children of Central India.PLoS One. 2016 May 18;11(5):e0155808.
  • 3 Ou Anyanwu,Rc Ibekwe And Ml Orjı. Nocturnal Enuresis Among Nigerian Children And Its Association With Sleep, Behavior And School Performance Indian Pediatrics Volume 52_July15, 2015 P:587-589.
  • 4 Strömgren A, Thomsen PH.Personality traits in young adults with a history of conditioning-treated childhood enuresis. Acta Psychiatr Scand. 1990 Jun;81(6):538-41.5 Aydın S, Sanli A, Celebi O, Tasdemir O, Paksoy M, Eken M, Hardal U, Ayduran E. Prevalence of adenoid hypertrophy and nocturnal enuresis in primary school children in Istanbul, Turkey.Int J Pediatr Otorhinolaryngol. 2008 May;72(5):665-8.
  • 6 Muhsin Balaban , Alper Aktas , Cuneyd Sevinc, Ugur Yucetas. The relationship of enuresis nocturna and adenoid hypertrophy.Archivio Italiano di Urologia e Andrologia 2016; 88, 2.
  • 7 Karakas HB, Mazlumoglu MR, Simsek E. The role of upper airway obstruction and snoring in the etiology of monosymptomatic nocturnal enuresis in children. Eur Arch Otorhinolaryngol. 2017 Jul;274(7):2959-2963.
  • 8 Annesi-Maesano I, Didier A, Klossek M, Chanal I, Moreau D, Bousquet J. The score for allergic rhinitis (SFAR): a simple and valid assessment method in population studies. Allergy 2002; 57: 107-14.
  • 9 Cingi C, Songu M, Ural A, Annesi-Maesano I, Erdogmus N, Bal C, et al. The Score For Allergic Rhinitis study in Turkey. Am J Rhinol Allergy 2011;25:333-7.
  • 10 L. Brodsky, L. Moore, J.F. Stanievich, A comparison of tonsillar size and oropharyngeal dimensions in children with obstructive adenotonsillar hypertrophy, Int. J. Pediatr. Otorhinolaryngol; 1987: 13: 149–56.
  • 11 B. J. Sadock and V. A. Sadock, Kaplan and Sadocks Comprehensive Textbook of Psychiatry, vol. 2, Lippincott Williams &Wilkins, Philadelphia, Pa, USA, 2000.
  • 12 Müferret Ergüven, Yalçın Çelik, Murat Deveci, Nurdan Yıldız Etiological risk factors in primary nocturnal enuresis. Türk Pediatri Arşivi 2004; 39: 83- 7.
  • 13 Migueis DP, Thuler LC, Lemes LN, Moreira CS, Joffily L, Araujo-Melo MH. Systematic review: the influence of nasal obstruction on sleep apnea. Braz J Otorhinolaryngol. 2016 Mar-Apr;82(2):223-31.
  • 14 R.M. Bland, S. Bulgarelli, J.C. Ventham, D. Jackson, J.J. Reilly, J.Y. Paton, Total energy expenditure in children with obstructive sleep apnoea syndrome, Eur. Respir. J. 2001:18 164–9.
  • 15 Kovacevic L, Wolfe-Christensen C, Lu H, Toton M, Mirkovic J, Thottam PJ, Abdulhamid I, Madgy D, Lakshmanan Y.Why Does adenotonsillectomy not correct enuresis in all children with sleep disordered breathing?. J Urol. 2014 May;191(5 Suppl):1592-6.
  • 16 Weider DJ. ve arkWeider DJ, Sateia MJ, West RP. Nocturnal enuresis in children with upper airway obstruction. Otolaryngol Head Neck Surg. 1991 Sep;105(3):427-32.
  • 17 Tsai JD, Chen HJ, Ku MS, Chen SM, Hsu CC, Tung MC, Lin CC, Chang HY, Sheu JN. Association between allergic disease, sleep-disordered breathing, and childhood nocturnal enuresis: a population-based case-control study. Pediatr Nephrol. 2017 Dec;32(12):2293-2301.
There are 16 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Alper Şen 0000-0003-0505-5214

Yavuz Güler This is me 0000-0001-7872-4701

Publication Date August 29, 2019
Submission Date June 19, 2019
Acceptance Date July 31, 2019
Published in Issue Year 2019 Volume: 16 Issue: 2

Cite

Vancouver Şen A, Güler Y. Evaluation of the relationship between upper airway obstruction and primary nocturnal enuresis. Harran Üniversitesi Tıp Fakültesi Dergisi. 2019;16(2):316-20.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty