Treating asthma in patients with enuresis: repercussions on urinary symptoms

Abstract

Background: Children presenting enuresis are more likely to be asthmatics. The association between enuresis and sleep-disordered breathing has already been demonstrated and several studies have shown at least partial improvement of two thirds or more of the cases of enuresis adenoidectomy. Studies have already described associations between enuresis and allergies but do not assess the repercussions of allergy treatment in enuretics. Objective: This study aims to evaluated whether asthma treatment alters the course of enuresis and whether there is any predictive factor associated with this improvement. Materials and Methods: Twenty patients (5 - 12 years old) with uncontrolled enuresis and asthma, received treatment for asthma. Children were also assessed for the presence of rhinitis and other allergies. The control of asthma was confirmed by a validated questionnaire and primary enuresis by clinical history and wet night diaries. Patients received only asthma treatment. Results: At least partial improvement of enuresis was observed in 55% of the patients with an increase in 64.4% in the number of dry nights at the end of the study (p=0.01). The “presence of other allergies” and “obstruction seen in nasal endoscopy” positively influenced the improvement of urinary symptoms (OR = 3.350; CI 0.844–13.306) and (OR=1.272; CI 0.480-3.370), respectively. Discussion: Until now, only patients presenting upper airway obstruction were known to benefit from the improvement of urinary symptoms when undergoing treatment for their respiratory problems. In our study, we found at least partial improvement in enuresis in 55% of our patients, with only clinical asthma treatment. Conclusion: Controlling asthma in children with primary enuresis resulted in a significant increase in dry nights.

Enuresis and Dysfunctional Voiding in Pediatric Asthma and/or Allergic Rhinitis Patients

“…It is a known fact that there is a connection between airway obstruction and enuresis. The association between nocturnal enuresis and upper airway obstruction due to allergic rhinitis or obstructive sleep apnea has already been documented (1)(2)(3)(4)(5)(6)(7). We designed our study to reveal the relationship between incontinence/enuresis and allergic diseases such as asthma and/or allergic rhinitis.…”

“…Dysfunctional voiding or voiding dysfunction can be briefly defined as having problems with storing the urine in the bladder or emptying the bladder or both. The frequency of monosymptomatic enuresis is found to be increased among pediatric patients with allergic diseases, and there are certain studies demonstrating the relationship between nocturnal enuresis and asthma (3,4).…”

“…Obstructive sleep apnea and snoring are found to be associated with urinary incontinence (5). In a few studies, it has also been documented that allergic diseases are also related with urinary incontinence, and the relationship between nocturnal enuresis and asthma has also been documented (1,4,6).…”

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“…Dr. Dahan and collegues form Brazil performed on page 590 ( 4 ) an interesting study about the asthma treatment in patients with enuresis: and the repercussions on urinary symptoms and concluded that controlling asthma in children with primary enuresis resulted in a significant increase in dry nights.…”