The abnormal urodynamic findings as a predictor of complete response to treatment in patients with complicated nocturnal enuresis

Objective: Patients with complicated nocturnal enuresis might show poor response to various forms of treatments, the purpose of this study is to urodynamically assess their bladder function and capacity aiming to predict the underlying cause for their problem and to assess their response to treatment with desmopressin and anticholinergics(oxybutynin). Patients and methods: A retrospective study of 63 patients (50 female and 13 male). Their age ranged between 5-14 years, complaining of complicated nocturnal enuresis. Conducted at the urology clinic in Jordan University Hospital in Amman. All patients underwent urodynamic study, their data were analyzed, and treatment was established accordingly. Response was compared between patients having bladder instability and those with stable bladder, also between those with normal cystometric capacity and those with reduced cystometric capacity. Results: Bladder instability was reported in 55 patients (87.3%) as compared to 8 patients (12.7%) with stable bladder. Also 52 patients (82.5%) had reduced bladder capacity and 11 patients (17.5%) had normal bladder capacity. Of 52 patients with reduced cystometric capacity, 42 patients (80.7%) had partial or no response to treatment. Conclusion: Management of patients with complicated nocturnal enuresis is challenging, and needs an elaborate efforts to settle the cause(s). Bladder instability and reduced bladder capacity represent significant part of the underlying etiologies. The reduced bladder capacity is a reliable predictor of response to treatment with desmopressin and anticholinergics in this group of patients.