Tonsillektomi ve adenoidektominin pediatrik hastalarda enurezis nokturna üzerine etkisi

Amaç: Enürezis nokturna (EN) çocuklarda sık görülen aralıklı gece idrar kaçırmaları ile karakterize olan bir durumdur. Üst solunum yolu obstrüksiyonun pediatrik popülasyonda en önemli nedenlerinin başında tonsil ve adenoid hipertrofileri gelmektedir. Bu çalışmada tonsil hipertofisi ve adenoid hipertrofisi tanısı alan hastalarda tonsillektomi, adenoidektominin ve adenotonsillektominin EN üzerine etkisini incelenmesi amaçlandı.Gereç Ve Yöntem: Çalışmaya Mayıs 2015 ile Mayıs 2016 tarihleri arasında üroloji polikiniğine başvurmuş, tuvalet eğitimini tamamlamış ve yaşları 5 ile 16 arasındaki enürezis nokturna tanısı konulmuş olan, ağzı açık uyuma, horlama, uykuda nefes durma şikayeti olan 30 çocuk hasta dahil edildi. Tüm hastalar detaylı kulak,burun, boğaz muayenesi ve fleksibl endoskopik muayenesi yapıldı. Hastalar tonsil ve adenoid büyüklüklerine göre gruplandırıldı. Hastaların demografik ve muayene bulguları kayıt edildi. Hastalar tonsil ve adenoidlerin durumuna göre opere edildi ve postoperatif 6 ay sonra kontrolleri yapıldı .Bulgular: Çalışmaya katılan bireylerin ortalama yaşları 9.36 ± 2.85 idi. 21(70 %) hastaya adenoidektomi uygulanırken 5 (16.6%) hastaya tonsillektomi , 4 (13.3 %) hastaya adenotonsillektomi yapıldı.. Cerrahi uygulanan hastaların postopertif 6 ay sonra yapılan kontrollerinde adenoidektomi yapılan 15 (71.4%) hastada ve tonsillektomi yapılan 1 (20%), adenotonsillektomi yapılan 2 (50%) hastada enürezis nokturna şikayetlerinin tamamen ortadan kalktığı izlendi. Böylece preoperatif ve postoperatif 6. ayda yapılan değerlendirmede, cerrahi sonrası enürezis nokturna şikayetlerinde düzelme açısından istatistiksel anlamlı fark olduğu görüldü (p‹0.01). Sonuç: Sonuç olarak enürezis nokturna hastalarında tonsil ve adenoid hipertrofisi nedeniyle üst solunum yolu obstrüksiyonun cerrahisi enürezis nokturna şikayetlerinin azalmasına katkı sağlayabilir.

Anahtar Kelimeler:

Tonsillektomi, edenoidektomi, enürezis nokturna

The effect of tonsillectomy and adenoidectomy on enurezis nocturna in pediatric patients

Aim: Enuresis nocturna (EN) is a condition that is characterized by frequent intermittent night-time incontinence in children. The aim of this study was to investigate the effect of tonsillectomy and adenoidectomy on EN in patients with tonsil hypertrophy and adenoid hypertrophy.Material and Method: Thirty pediatric patients who were admitted to urology clinic between May 2015 and May 2016, who had completed toilet training and who were diagnosed with enuresis nocturna between the ages of 5 and 16 and had open mouth, snoring, breathing in sleep, were included in the study. A detailed ear,nose,throat examination and flexible endoscopic examination were performed in all patients. Patients were grouped according to tonsil and adenoid size. Demographic and examination findings of the patients were recorded. Patients were operated according to the condition of tonsils and adenoids, and 6 months later, control was performed.Results: The mean age of the participants was 9.36 ± 2.85. While 21 (70%) patients underwent adenoidectomy, 5 (16.6%) patients underwent tonsillectomy and 4 (13.3%) underwent tonsillectomy and adenoidectomy. Postoperative follow-up 6 months later, 15 (71.4%) patients underwent adenoidectomy and 1 (20%) underwent tonsillectomy, and 2 (50%) patients who underwent tonsillectomy and adenoidectomy were completely followed by the disappearance of complaints nocturnal enuresis. Thus, in the preoperative and postoperative 6th month evaluation, there was a statistically significant difference in the improvement of complaints of enuresis nocturna after surgery (p‹0.01). Conclusion: In conclusion, surgery for upper airway obstruction due to tonsil and adenoid hypertrophy in enuresis nocturna patients may contribute to the reduction of complaints of enuresis nocturna.

Keywords:

Tonsillectomy, adenoidectomy, enuresis nocturna,

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