Role of Uroflowmetry in Determining Pharmacological Treatment Requirements in Children with Enuresis
DOI:
https://doi.org/10.58600/eurjther3155Keywords:
anticholinergics, enuresis, desmopressin, uroflowmetryAbstract
Objective: Nocturnal enuresis denotes the involuntary expulsion of urine during sleep, and several therapeutic approaches have been employed to address and manage this condition. This study aimed to evaluate the efficacy of uroflowmetry (UF) in evaluating treatment requirements in patients with primary monosymptomatic enuresis (PME) receiving pharmacological therapy.
Methods: Files of patients with PME between December 2022–May 2024 were analyzed. Patients who were treated with desmopressin alone or desmopressin plus anticholinergics were included. Demographics, clinical data, desmopressin dosage, anticholinergic use, and UF parameters were collected. Voided volume/expected bladder capacity and postvoid residual (%) were calculated using UF data. Group 1 received 120 mcg desmopressin, Group 2 240 mcg desmopressin, and Group 3 240 mcg desmopressin plus anticholinergic. Treatment success was defined as one or fewer bedwetting episodes per month.
Results: A total of 103 children with a mean age of 8.41 ± 2.38 years were included. Group 1 had 55 (53.4%) patients, Group 2 34 (33.2%), and Group 3 14 (13.6%). Seven (6.8%) patients had staccato curves, but repeat UF with electromyography (EMG) indicated normal. No significant differences were found in age, gender, enuresis episodes/week, maximal urine flow rate, and calculated UF parameters across groups (p > 0.05 for all). Daily voiding frequency was lower in Group 1 compared to Group 2 and Group 3 (p < 0.001 for both). Group 3 had higher Dysfunctional Voiding Symptom Scores (DVSS) than Group 2 and Group 1 (p = 0.036 and p < 0.001, respectively). Group 2 also had higher DVSS than in Group 1 (p = 0.001).
Conclusion: UF demonstrated limited effectiveness to characterize patients requiring treatment escalation. Retesting pathological curves increases workload. High DVSS may be helpful in determining the necessity of treatment intensity, including the desmopressin dose and using anticholinergics. A higher voiding frequency per day may also indicate the necessity of higher treatment intensity.
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