標準的泌尿治療對兒童原發性夜尿症且有較大的最大排尿量者是有效的
彭瓊慧、張尚仁、楊緒棣、羅啟文
台北慈濟醫院 外科部 泌尿科 暨 慈濟大學醫學院
Standard Urotherapy Was Effective in Children With Primary Nocturnal Enuresis and Large Maximal Voided Volume
Chiung-Hui Peng, Shang-Jen Chang, Stephen S. Yang, Chi-Wen Lo
Division of Urology, Taipei Tzu Chi Hospital, New Taipei, Taiwan and School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan.
Purpose: A recent randomized control failed to show the benefits of standard urotherapy in children with primary nocturnal enuresis (PNE). Herein, we correlated the results of urotherapy and maximal voided volume (MVV) in children with PNE.
Materials and Methods: Children with PNE recorded frequency volume chart (FVC) for 48 hours, and underwent two sets of uroflowmetry and postvoid residual urine (PVR). Number of wet nights was recorded before and after urotherapy for at least 7 days. Standard urotherapy for 4 weeks and treatment outcomes were in accordance with the recommendation of ICCS.
Results: Based on FVC, 12 children were classified as Group A (MVV >100% EBC), 24 Group B (MVV between 60-100% EBC), and 11 Group C (MVV <60% EBC). Between groups, there was no statistical difference in age. Mean and median MVV were statistically higher in Group A (416.7, 400ml) than group B (225.2, 245ml), and group C (146.3, 158). Mean and median MVV of group A were 154% and 136 % EBC, those of group B were 81% and 77% EBC, and those of group C were 50% and 53% EBC, respectively. Treatment responses (complete + partial) were statistically higher in group A than group B and C (p=0.02).
Conclusion: Standard urotherapy was more effective in children with a maximal voided volume >100% expected bladder capacity. Larger and prospective studies are required to prove the concept of urotherapy in this specific group of patients.