Impact of spina bifida occulta on the response to treatment of primary nocturnal enuresis

Abstract

Objective To explore the impact of spina bifida occulta (SBO) on the response to treatment of primary nocturnal enuresis (PNE). Methods Between July 2011 to December 2013, clinical records were reviewed for 163 PNE children. Bedwetting appeared at least once weekly. And all of them had arousal dysfunction. Children with other organic urological diseases or symptoms suggestive of spinal dysraphism were excluded. Bladder diary was recorded before PNE treatment and it was maintained monthly during treatment. Functional bladder capacity (FBC) was collected from bladder diary. SBO children were examined by radiography. They were divided into two groups of SBO and non-SBO. And the same treatment was offered. The weekly frequency of enuretic episodes was recorded. The follow-up frequency was monthly and lasted at least 6 months. Treatment responses were compared between children with and without SBO. Results Among 163 children, SBO was detected in 122 children (74.8%)(9.8±2.3 years), 69 were boys. The signs of SBO were present in 55 children. Among 41 non-SBO children (9.5±2.5 years), there were 24 boys. No inter-group significance existed in age (P>0.05) and FBC pre-treatment (SBO (216.5±49.5) ml and non-SBO (217.4±47.3) ml, P>0.05). There was significant inter-group difference in increment of FBC post-treatment [SBO group: (11.9±4.4) vs non-SBO group: (24.1±6.6) ml, P 0.05). In SBO group, 25(20.5%) patients showed complete response, 25(20.5%) response, 34(27.9%) partial response and 38(31.1%) no response. Among 41 non-SBO patients, 20(48.8%) showed complete response, 10(24.4%) response, 9(22.0%) partial response and 2(4.8%) no response. Significant inter-group difference existed in outcomes. And complete response was more likely in non-SBO children (P<0.001). Conclusions The presence of SBO significantly affects the treatment responses of PNE patients. Key words: Meclofenoxate; Anisodamine; Primary nocturnal enuresis; Spina bifida occulta