Nocturnal enuresis in young adults, a nightmare of patients with schizophrenia?
年青成年男性尿床,思覺失調症患者的惡夢?
Te-Wei Chang張德撝1、Weiming Cheng程威銘1,2、Yi-Chun Chiu邱逸淳1,2、Shih-Chi Hong洪士奇1
1Division of Urology, Department of Surgery, ZhongXiao Branch, Taipei City Hospital, Taipei, Taiwan
臺北市立聯合醫院忠孝院區泌尿外科
2School of Medicine, National Yang-Ming University, Taipei, Taiwan國立陽明大學
Introduction
Nocturnal enuresis (NE) is common in children and the elderly, but a rare condition in young adults, and currently there are no treatment guidelines. In the present study, we evaluated the possible causes of and treatments for NE in patients without neurological diseases in our hospital.
Materials and methods
Medical records of adult patients younger than 50 years of age, who visited our urologic clinics for NE between 1999 and 2017 were retrospectively reviewed. Those with neurogenic bladder were excluded. Descriptive statistics were used to present the tentative diagnosis of nocturnal enuresis, concomitant medication, and possible treatments.
Results
There were 22 patients included for analysis. All of them were males and the average age at diagnosis was 37.2 ± 8.7 years. Fourteen patients (63.6%) had psychiatric comorbidities, including schizophrenia, major depressive disorder, and anxiety disorder (Table 1). Two (9.1%) complaining of NE were found to have type 2 diabetes later. Obstructive sleep apnea (OSA) was suspected to result in NE in one patient (4.5%). No obvious causes could be identified in the rest four patients. Among patients with psychiatric disorders, 13 (92.9%) used at least two medications at the same time (Table 2). Treatments for NE is diverse, including desmopressin, imipramine, and alpha blockers (Table 3).
Conclusion
The possible etiologies of NE in young adults are diverse and different from children and the elderly. Male patients with psychiatric disorders, especially schizophrenia, are at risk of developing NE. Hypnotics and anti-psychotics might exacerbate such condition. Urologists should also be aware of the possibility of type 2 diabetes and OSA in patients with NE. Currently there is no single effective treatment for NE.