Utility of Voiding Dysfunction Symptom Score in Diagnosis and Treatment of Enuresis Nocturna

Amaç: Enürezis nokturnası olan çocukların değerlendirilmesinde işeme bozuklukları semptom skorunun (İBSS) etkinliğinin araştırılmasıdır.Gereç ve Yöntem: Enürezis nokturna nedeniyle başvuran 400 çocuk çalışmaya dahil edildi. Çocukların hepsi fizik inceleme, İBSS, idrar analizi ve işeme günlüğü ile değerlendirildi. İnceleme sonrası enürezis nokturnası olan çocuklar üroterapi ve/veya desmopressin ile tedavi edilirken eşlik eden aşırı aktif mesanesi olanlar ise antikolinerjikler ile tedavi edildi. Uygulanan tedavilerin başarısı ve İBSS değerleri arasındaki ilişki karşılaştırıldı.Bulgular: Çalışmaya katılan çocukların iki yüz kırk beşi erkek (%61,25), yüz elli beşi kız (%8,75) ve ortalama yaşları 7,6±3,0 olarak saptandı. Ortalama İBSS skoru 9,2±6,3 olarak saptandı. Çocukların %35'inde enürezis nokturnaya eşlik eden gündüz semptomları vardı. İBSS değeri dokuz ve üzeri olan yüz yirmi altı çocuk (%31,5) antikolinerjik ilaçlar ile tedavi edildi. İBSS monosemptomatik olmayan enürezis nokturnası olan çocuklarda tedavi başarısının ayırt edilmesinde anlamlı bir fark göstermedi. Ancak üroterapi ve desmopressin ile tedavi edilen çocuklarda tedavi yanıtına göre İBSS değerlerinde anlamlı fark saptandı. Sonuç: Çalışmamızda monosemptomatik enürezis nokturnası olan çocukların tedavi sonrası İBSS değerinin düştüğü gösterildi. Uygun tedavi sonrası İBSS değerinde düzelme olmayan çocukların tedavisinin gözden geçirilmesi tedavi başarısını artırabilir

Enürezis Nokturnanın Tanı ve Tedavisinde İşeme Bozuklukları Semptom Skorunun Etkinliği

Objective: The aim of this study was to determine the effectiveness of the voiding dysfunction symptom score (VDSS) in evaluation of children with nocturnal enuresis.Materials and Methods: Four hundred children with nocturnal enuresis were included in the study. They were evaluated with VDSS, physical examination, urinalysis and 2-day voiding diary. All children with nocturnal enuresis symptoms were treated with desmopressin and/or urotherapy. However, children with overactive bladder symptoms were also treated with anticholinergics. Treatment success and change in VDSS were compared and assessed between different treatment methods. Results: Two hundred forty-five children (61.25%) were male and 155 (38.75%) were female. The mean age was 7.6±3.0 years . The mean VDSS was 9.2±6.3. 35% of children with nocturnal enuresis had concomitant daytime symptoms. 126 children (31.5%) had a VDSS of nine or above and majority of these children were treated with anticholinergic therapy. VDSS questionnaire could not help determine treatment success in children with non-monosymptomatic nocturnal enuresis. However, children treated with urotherapy and desmopressine showed significant difference in VDSSs according to their treatment response.Conclusion: VDSS has shown to decrease after treatment in children with mono-symptomatic nocturnal enuresis. The treatment strategies should be checked and modified if VDSS does not decrease after proper therapy as this would increase the success of treatment

Kaynakça

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