Not only enuresis: do not disregard organic disorders

Not only enuresis: do not disregard organic disorders

Authors

  • Pietro Ferrara Department of Medicine and Surgery, Università Campus Bio-Medico, Roma, Italy ; Operative Research Unit of Pediatrics, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy https://orcid.org/0000-0001-9449-3464
  • Giovanna Magli Institute of Pediatrics, Catholic University, Rome, Italy
  • Elena Malavolta Institute of Pediatrics, Catholic University, Rome, Italy https://orcid.org/0000-0001-7968-422X
  • Emidio Procaccini Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome
  • Luca Massimi Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
  • Antonio Gatto Department of Pediatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy https://orcid.org/0000-0002-8778-9328

Keywords:

Enuresis, encopresis, synovial cyst, hydrosyringomyelia, lipoma.

Abstract

Nocturnal enuresis (NE) is a common condition in the pediatric age. NE is defined as an intermittent bedwetting with any frequency while sleeping in children. NE is classified into primary form (patient never had achieved nocturnal urinary control) or secondary form (children with a period of 6 consecutive months of night-time urinary control before incontinence, which is generally associated with organic or psychological causes). Moreover, NE could be monosymptomatic (MNE) or non-monosymptomatic (NMNE), depending on the presence of daytime incontinence or any other lower urinary tract symptoms (LUTS).

We report a 7-year- old female with a history of recent onset of sphincter troubles and recurrent low urinary tract infections. She presented urinary urgency associated to daytime incontinence, bedwetting almost every night in the previous 3 months and sometimes encopresis. The physical and neurological examination was silent, no psychological or social problem intercurred. As first approach, she was treated with deamino-delta-D-arginine vasopressin (dDAVP) 120 mcg associated with oxybutynin 5 mg and educational therapy, for 3 months without benefits. So, she underwent a magnetic resonance imaging (MRI) of the spinal cord, that highlighted the presence of hydrosyringomyelia from D6 to D10, lipoma of the terminal filum and the presence of synovial cyst between L5-S1.

This case remarks that in secondary NMNE, any possible organic cause must be investigated.

References

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Brown BJ, Habelt S, Koral K, Sacco D, Herman JH, Baker LA. Secondary nocturnal enuresis caused by central sleep apnea from Chiari malformation type 1. J Pediatr Urol. 2010 Jun;6(3):265-269. doi: 10.1016/j.jpurol.2009.08.009.

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Published

05-12-2023

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How to Cite

1.
Ferrara P, Magli G, Malavolta E, Procaccini E, Massimi L, Gatto A. Not only enuresis: do not disregard organic disorders. Acta Biomed [Internet]. 2023 Dec. 5 [cited 2024 Jul. 24];94(6):e2023223. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/14931