原發性尿床兒童過動症合併下泌尿道症狀的相關性及Minirin效果的評估
楊登凱1,2、郭雅君3、楊弘如3、張宏江2、黃國皓2
1耕莘醫院永和分院 外科部；2國立台灣大學附設醫院 泌尿部，3內科部 4 臺北市立聯合醫院和平院區 精神科
ADHD symptoms and daytime voiding symptoms in children with primary enuresis: an observational study to evaluate the effectiveness of desmopressin treatment
Teng-Kai Yang 1,2, Ya-Jun Guo3, Hung-Ju Yang1, Hong-Chiang Chang2, Kuo-How Huang2
1Department of Surgery, Yongho Cardinal Tien Hospital, New Taipei city, Taiwan.
2Department of Urology and 3Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan 4Department of Psychiatrics, Taipei City Hospital, Heping Branch, Taipei, Taiwan
Purpose:
To evaluate the effectiveness of presence of desmopressin in treating primary enuresis (PE) for children with attention deficit-hyperactivity disorder (ADHD) symptoms.
Materials and Methods:
Children aged from 5 to 12 years with the chief complain of PE treated with desmopressin were enrolled in pediatric urology clinics. The parent-reported SNAP-IV questionnaire was used to evaluate ADHD symptoms (cutoff value: 90th percentile). Voiding symptoms were assessed by the Dysfunctional Voiding Scoring System (DVSS) questionnaire. The responses to desmopressin were analyzed.
Results:
The study sample comprised 68 children; 27 (39.7%) presented with ADHD symptoms and 41 (60.3%) with non-ADHD symptoms. The total DVSS score in the ADHD symptoms group was significantly higher than in the non-ADHD symptoms group (7.72 vs. 5.65, p=0.05). In the ADHD symptoms group, there were significantly higher score in the “Pee 1-2 times/day”, “can’t wait” subscale of DVSS and lower sleep quality based on the Pediatric Sleep Quality Questionnaire, as well as significantly lower peak flow rate and voided volume. The responses to desmopressin for enuresis were comparable between children with ADHD and non-ADHD symptoms.
Conclusions:
Approximately 39.7% of PE children presented with ADHD symptoms at urologic clinics. PE children with ADHD symptoms had higher risk of daytime LUTS and comparable response to desmopressin treatment for PE. To evaluate ADHD symptoms and daytime voiding symptoms is important in children with PE.