Öz
Aim: Enuresis nocturna (EN)
is a condition that is characterized by frequent intermittent night-time
incontinence in children. The aim of this study was to investigate the effect
of tonsillectomy and adenoidectomy on EN in patients with tonsil hypertrophy
and adenoid hypertrophy.
Material and Method:
Thirty pediatric patients who were admitted to urology clinic between May 2015
and May 2016, who had completed toilet training and who were diagnosed with
enuresis nocturna between the ages of 5 and 16 and had open mouth, snoring,
breathing in sleep, were included in the study. A detailed ear,nose,throat
examination and flexible endoscopic examination were performed in all patients.
Patients were grouped according to tonsil and adenoid size. Demographic and
examination findings of the patients were recorded. Patients were operated
according to the condition of tonsils and adenoids, and 6 months later, control
was performed.
Results: The mean age of
the participants was 9.36 ± 2.85. While 21 (70%) patients underwent adenoidectomy,
5 (16.6%) patients underwent tonsillectomy and 4 (13.3%) underwent
tonsillectomy and adenoidectomy. Postoperative follow-up 6 months later, 15
(71.4%) patients underwent adenoidectomy and 1 (20%) underwent tonsillectomy,
and 2 (50%) patients who underwent tonsillectomy and adenoidectomy were
completely followed by the disappearance of complaints nocturnal enuresis.
Thus, in the preoperative and postoperative 6th month evaluation, there was a
statistically significant difference in the improvement of complaints of
enuresis nocturna after surgery (p‹0.01).
Conclusion: In conclusion,
surgery for upper airway obstruction due to tonsil and adenoid hypertrophy in
enuresis nocturna patients may contribute to the reduction of complaints of
enuresis nocturna.
Anahtar Kelimeler
Kaynakça
- 1. Brodsky L. Modern assessment of tonsils and adenoids. Pediatr Clin North Am 1989; 36: 1551–1569.2. Li AM, Wong E, Kew J, Hui S, Fok TF. Use of tonsil size in the evaluation of obstructive sleep apnoea. Arch Dis Child 2002; 87: 156-15 3- Lehmann KJ, Nelson R, MacLellan D, Anderson P, Romao RL. The role of adenotonsillectomy in the treatment of primary nocturnal enuresis in children: A systematic review. Journal of Pediatric Urology .2018; 14, 53.e1-53.e84- Kaya KS, Türk B, Erol ZN, Akova P, Coşkun BU Pre- and post-operative evaluation of the frequency of nocturnal enuresis and Modified Pediatric Epworth Scale in pediatric obstructive sleep apnea patients. Int J Pediatr Otorhinolaryngol. 2018 ;105:36-39.5.Neveus, T, von Gontard A, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children’s Continence Society. J Urol 2006; 176: 314-324. 6.Weissbach A, Leiberman A, Tarasiuk A et al. Adenotonsilectomy improves enuresis in children with obstructive sleep apnea syndrome. Int J Pediatr Otorhinolaryngol 2006; 70: 1351-1357. R. C. Wang, T. P. Elkins, D. Keech, A. Wauquier, D. Hubbard. Accuracy of clinical evaluation in pediatric obstructive sleep apnea. Otolaryngology: Head and Neck Surgery 1998; 118: 69–73.8. Kovacevic L, Lu H, Wolfe-Christensen C, Abdulhamid I, Thottam PJ, Lulgjuraj M, Madgy DN, Lakshmanan Y. Adenotonsillectomy Normalizes Hormones and Urinary Electrolytes in Children With Nocturnal Enuresis and Sleep-Disordered Breathing. Urology 2015; 86: 158-1619. Alexopoulos EI, Kostadima E, Pagonari I, Zintzaras E, Gourgoulianis K, Kaditis AG. Association between primary nocturnal enuresis and habitual snoring in children. Urology 2006; 68: 406–409.10. Jeyakumar A, Rahman SI, Armbrecht ES, Mitchell R. The association between sleep-disordered breathing and enuresis in children. Laryngoscope 2012; 122: 1873–1877. 11-Forsythe WI, Redmond A. Enuresis and spontaneous cure rate. Study of 1129 enuretics. Arch Dis Child 1974; 49: 259-263. 12. Kalorin CM, Mouzakes J, Gavin JP et al. Tonsillectomy does not improve bedwetting: results of a prospective controlled trial. J Urol 2010; 184: 2527-2531
Öz
Amaç: Enürezis
nokturna (EN) çocuklarda sık görülen aralıklı gece idrar kaçırmaları ile
karakterize olan bir durumdur. Üst
solunum yolu obstrüksiyonun pediatrik popülasyonda en önemli nedenlerinin
başında tonsil ve adenoid hipertrofileri gelmektedir. Bu çalışmada tonsil
hipertofisi ve adenoid hipertrofisi tanısı alan hastalarda tonsillektomi, adenoidektominin
ve adenotonsillektominin EN üzerine etkisini
incelenmesi amaçlandı.
Gereç Ve Yöntem: Çalışmaya Mayıs 2015 ile Mayıs 2016 tarihleri arasında üroloji
polikiniğine başvurmuş, tuvalet eğitimini tamamlamış ve yaşları 5 ile 16
arasındaki enürezis nokturna tanısı konulmuş olan, ağzı açık uyuma, horlama,
uykuda nefes durma şikayeti olan 30 çocuk hasta dahil edildi. Tüm hastalar
detaylı kulak,burun, boğaz muayenesi ve fleksibl endoskopik muayenesi yapıldı.
Hastalar tonsil ve adenoid büyüklüklerine göre gruplandırıldı. Hastaların
demografik ve muayene bulguları kayıt
edildi. Hastalar tonsil ve adenoidlerin durumuna göre opere edildi ve
postoperatif 6 ay sonra kontrolleri yapıldı .
Bulgular: Çalışmaya katılan bireylerin ortalama yaşları 9.36
± 2.85 idi. 21(70 %) hastaya adenoidektomi
uygulanırken 5 (16.6%) hastaya tonsillektomi , 4 (13.3 %) hastaya adenotonsillektomi
yapıldı.. Cerrahi uygulanan hastaların postopertif 6 ay sonra yapılan kontrollerinde
adenoidektomi yapılan 15 (71.4%) hastada ve tonsillektomi yapılan 1 (20%), adenotonsillektomi
yapılan 2 (50%) hastada enürezis nokturna şikayetlerinin tamamen ortadan
kalktığı izlendi. Böylece preoperatif ve postoperatif 6. ayda yapılan
değerlendirmede, cerrahi sonrası enürezis nokturna şikayetlerinde düzelme
açısından istatistiksel anlamlı fark olduğu görüldü (p‹0.01).
Sonuç: Sonuç
olarak enürezis nokturna hastalarında tonsil ve adenoid hipertrofisi
nedeniyle üst solunum yolu
obstrüksiyonun cerrahisi enürezis nokturna şikayetlerinin azalmasına katkı
sağlayabilir.
Anahtar Kelimeler
Kaynakça
- 1. Brodsky L. Modern assessment of tonsils and adenoids. Pediatr Clin North Am 1989; 36: 1551–1569.2. Li AM, Wong E, Kew J, Hui S, Fok TF. Use of tonsil size in the evaluation of obstructive sleep apnoea. Arch Dis Child 2002; 87: 156-15 3- Lehmann KJ, Nelson R, MacLellan D, Anderson P, Romao RL. The role of adenotonsillectomy in the treatment of primary nocturnal enuresis in children: A systematic review. Journal of Pediatric Urology .2018; 14, 53.e1-53.e84- Kaya KS, Türk B, Erol ZN, Akova P, Coşkun BU Pre- and post-operative evaluation of the frequency of nocturnal enuresis and Modified Pediatric Epworth Scale in pediatric obstructive sleep apnea patients. Int J Pediatr Otorhinolaryngol. 2018 ;105:36-39.5.Neveus, T, von Gontard A, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children’s Continence Society. J Urol 2006; 176: 314-324. 6.Weissbach A, Leiberman A, Tarasiuk A et al. Adenotonsilectomy improves enuresis in children with obstructive sleep apnea syndrome. Int J Pediatr Otorhinolaryngol 2006; 70: 1351-1357. R. C. Wang, T. P. Elkins, D. Keech, A. Wauquier, D. Hubbard. Accuracy of clinical evaluation in pediatric obstructive sleep apnea. Otolaryngology: Head and Neck Surgery 1998; 118: 69–73.8. Kovacevic L, Lu H, Wolfe-Christensen C, Abdulhamid I, Thottam PJ, Lulgjuraj M, Madgy DN, Lakshmanan Y. Adenotonsillectomy Normalizes Hormones and Urinary Electrolytes in Children With Nocturnal Enuresis and Sleep-Disordered Breathing. Urology 2015; 86: 158-1619. Alexopoulos EI, Kostadima E, Pagonari I, Zintzaras E, Gourgoulianis K, Kaditis AG. Association between primary nocturnal enuresis and habitual snoring in children. Urology 2006; 68: 406–409.10. Jeyakumar A, Rahman SI, Armbrecht ES, Mitchell R. The association between sleep-disordered breathing and enuresis in children. Laryngoscope 2012; 122: 1873–1877. 11-Forsythe WI, Redmond A. Enuresis and spontaneous cure rate. Study of 1129 enuretics. Arch Dis Child 1974; 49: 259-263. 12. Kalorin CM, Mouzakes J, Gavin JP et al. Tonsillectomy does not improve bedwetting: results of a prospective controlled trial. J Urol 2010; 184: 2527-2531
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Aralık 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 10 Sayı: 4 |
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