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Renal bladder ultrasound evaluation in monosymptomatic primary nocturnal enuresis: is it really necessary?

Authors
  • Kovacevic, Larisa1
  • Wolfe-Christensen, Cortney1
  • Mirkovic, Jelena1
  • Yih, Jessica1
  • Lakshmanan, Yegappan1
  • 1 Children’s Hospital of Michigan, Department of Pediatric Urology, 3901 Beaubien Blvd, Detroit, Michigan, 48201, USA , Detroit (United States)
Type
Published Article
Journal
Pediatric Nephrology
Publisher
Springer-Verlag
Publication Date
Jan 18, 2014
Volume
29
Issue
7
Pages
1189–1194
Identifiers
DOI: 10.1007/s00467-013-2742-y
Source
Springer Nature
Keywords
License
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Abstract

BackgroundPublished guidelines regarding radiographic imaging in the evaluation of monosymptomatic primary nocturnal enuresis (MPNE) are not followed. We aimed to evaluate the prevalence of urological abnormalities on renal/bladder ultrasound (RBUS) in children with MPNE and to compare the RBUS findings in children with and without MPNE.MethodsRetrospective data collection in all children aged 5–17 years seen for the initial evaluation of MPNE. Control group consisted of age- and sex-matched children who had abdominal ultrasound for other than bladder-/kidney-related causes. RBUS findings were analyzed with regard to the need for intervention and/or follow-up.ResultsWhile abnormalities on RBUS were seen in 12.54 % of enuretic children and in 5.38 % of controls (p = 0.004), the majority of these findings were clinically insignificant. Of those with abnormalities, only 4 enuretic children (1.43 %) required intervention and 8 (2.87 %) needed follow-up studies. These rates were not significantly different from the controls. However, enuretic children with RBUS abnormalities appear to be more resistant to treatment than enuretic children with normal RBUS (p = 0.002).ConclusionsA small proportion of abnormalities seen on RBUS in children with MPNE require intervention and/or further evaluation. The identification of insignificant RBUS findings could lead to unnecessary additional investigations owing to parental concern. Detailed history and a voiding diary may be sufficient in the initial evaluation of children with MPNE, although RBUS may play an important role in patients who are resistant to treatment.

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