1
|
de Rijk MM, Drake MJ, von Gontard A, Solomon E, Dmochowski R, Schurch B, van Koeveringe GA. Functional neuroimaging related to lower urinary tract sensations: Future directions for study designs and selection of patient groups: ICI-RS 2023. Neurourol Urodyn 2024; 43:1400-1408. [PMID: 37960970 DOI: 10.1002/nau.25333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVES Neuroimaging studies have advanced our understanding of the intricate central nervous system control network governing lower urinary tract (LUT) function, shedding light on mechanisms for urine storage and voiding. However, a lack of consensus in methodological approaches hinders the comparability of results among research groups and limits the translation of this knowledge to clinical applications, emphasizing the need for standardized methodologies and clinical utilization guidelines. METHODS This paper reports the discussions of a workshop at the 2023 meeting of the International Consultation on Incontinence Research Society, which reviewed uncertainties and research priorities to progress the field of neuroimaging in LUT control and dysfunction. RESULTS Neuroimaging holds great potential for improving our understanding of LUT control and pathophysiological conditions. To date, functional neuroimaging techniques have not yet achieved sufficient strength to make a direct clinical impact. Potential approaches that can improve the clinical utilization of neuroimaging were discussed and research questions proposed. CONCLUSIONS Neuroimaging offers a valuable tool for investigating LUT control, but it's essential to acknowledge the potential for oversimplification when interpreting brain activity due to the complex neural processing and filtering of sensory information. Moreover, technical limitations pose challenges in assessing key brain stem and spinal cord centers, particularly in cases of neurological dysfunction, highlighting the need for more reliable imaging of these centers to advance our understanding of LUT function and dysfunction.
Collapse
Affiliation(s)
- Mathijs M de Rijk
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Marcus J Drake
- Department of Surgery and Cancer, Imperial College, Hammersmith Hospital, London, UK
| | - Alexander von Gontard
- Parent-Child and Adolescent Department, Hochgebirgsklinik, Davos, Switzerland
- Governor Kremers Centre, Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Eskinder Solomon
- Urology Centre, Guy's and St Thomas' NHS Trust, London, UK
- Paediatric Nephro-Urology, Evelina Children's Hospital, London, UK
| | - Roger Dmochowski
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Brigitte Schurch
- Neuourology Unit, Clinique des Grangettes, Genève, Switzerland
- Department of Neuroscience, University Hospital Lausanne, Lausanne, Switzerland
| | - Gommert A van Koeveringe
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| |
Collapse
|
2
|
Koposov RA, Stickley A, Isaksson J, Ruchkin V. Enuresis in young offenders - a study on prevalence and mental health comorbidity. Front Psychiatry 2024; 15:1328767. [PMID: 38559400 PMCID: PMC10978753 DOI: 10.3389/fpsyt.2024.1328767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/19/2024] [Indexed: 04/04/2024] Open
Abstract
Background Enuresis is a common disorder in the school-age period, and is often associated with a variety of behavioral, psychological, and social problems. While early studies suggested an association between enuresis and delinquent behavior, there has been no recent research assessing the prevalence of enuresis and its comorbid psychopathology in young offenders. The aim of this study was to therefore assess the prevalence of enuresis and its associated psychiatric comorbidity in incarcerated young offenders. Methods The prevalence of past and current enuresis and comorbid psychopathology was assessed using a semi-structured psychiatric interview and self-reports from 366 incarcerated male young offenders [age 14 to 19 years (mean age = 16.4)] from Northern Russia. Results Seventy-three (20.0%) adolescents reported a previous history of enuresis, and in addition almost 10% of the youth reported current enuresis symptoms. Delinquent youth with enuresis did not significantly differ from other youth in the prevalence of comorbid psychiatric diagnoses when assessed by a clinical diagnostic interview, but had significantly higher levels of self-reported mental health problems, and suicidal ideation and attempts. Conclusion Problems with enuresis are common among delinquent youth and may be associated with increased mental health problems. Given the potentially increased risk for suicidal thoughts and behavior in young offenders with enuresis, comprehensive mental health screening of those who are detected with this condition should be considered in the juvenile justice system.
Collapse
Affiliation(s)
- Roman A. Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Epidemiology and Modern Technologies of Vaccination, Institute of Professional Education, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Stockholm, Sweden
| | - Johan Isaksson
- Department of Medical Sciences, Child and Adolescent Psychiatry Unit, Uppsala University, Uppsala, Sweden
- Center of Neurodevelopmental Disorders, Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institute and Stockholm Health Care Services, Stockholm, Sweden
| | - Vladislav Ruchkin
- Department of Medical Sciences, Child and Adolescent Psychiatry Unit, Uppsala University, Uppsala, Sweden
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Sala Forensic Psychiatric Clinic, Sala, Sweden
| |
Collapse
|
3
|
Ezodin N, Sarouei M, Khademlo M, Milani SH, Yousefi S, Mohammadjafari H. Comparison of the Efficacy of Tolterodine versus Oxybutynin in the Treatment of Children with Desmopressin-Resistant Enuresis: A Randomized Controlled Clinical Trial. Ethiop J Health Sci 2023; 33:611-620. [PMID: 38784212 PMCID: PMC11111179 DOI: 10.4314/ejhs.v33i4.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/09/2023] [Indexed: 05/25/2024] Open
Abstract
Background Enuresis, defined as involuntary nocturnal urination without any underlying organic disorder in a child expected to control urination, poses a common problem. This study evaluated the effectiveness of Tolterodine and Oxybutynin in children presenting with primary desmopressin-resistant enuresis. Materials and Methods A randomized clinical trial was undertaken involving 68 participants aged between 5 and 16 years, all suffering from primary enuresis. These patients were randomly assigned to one of two treatment groups for a three-month period: Group 1, treated with Oxybutynin and Desmopressin, and Group 2, treated with Tolterodine and Desmopressin. Data on demographics, clinical and laboratory findings, and subjective responses to treatment were gathered. The response was measured based on the frequency of wetting incidents per night and week and compared with pre-treatment data. Results Patients were divided into two groups (30 patients in Group 1 and 38 patients in Group 2). The mean age of the patients was 88.97±27.09 months. In the first treatment group, 6 out of 30 patients (20%) experienced a complete treatment response, as did 5 out of 38 patients (13.2%) in the second treatment group. This difference between the groups was not statistically significant. Seven patients (23%) in the Oxybutynin group and 13 patients (34%) in the Tolterodine group reported a lack of response to treatment, a difference that also lacked statistical significance. Conclusion For patients resistant to Desmopressin, the addition of anticholinergic drugs elicited a significant response in over half of the patients. However, no benefit was observed in using either Oxybutynin or Tolterodine in the treatment of Desmopressin-resistant enuresis.
Collapse
Affiliation(s)
- Neda Ezodin
- Department of pediatrics, Mazandaran University of Medical Sciences, Sari Iran
| | - MahboubehJafari Sarouei
- Pediatric infectious diseases research center, communicable Diseases institute, Mazandaran University of Medical Sciences, Sari Iran
| | | | | | - Sahar Yousefi
- Department of pediatrics, Mazandaran University of Medical Sciences, Sari Iran
| | - Hamid Mohammadjafari
- Pediatric infectious diseases research center, communicable Diseases institute, Mazandaran University of Medical Sciences, Sari Iran
| |
Collapse
|
4
|
Alshehri AA, Zaki MSH, Nour SO, Gadi WH, Zogel BA, Alfaifi SM, Masmali EM, Aburasain AB, Nour MO. Sleep-Disordered Breathing and Its Association with Nocturnal Enuresis at the Primary Schools in Saudi Arabia: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1074. [PMID: 37371305 DOI: 10.3390/children10061074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
The correlation between nocturnal enuresis (NE) and sleep-disordered breathing (SDB) was reported. We aim to determine whether there is an association between NE and SDB in children and to assess the prevalence of SDB and NE in primary school children aged 6-12 years in Saudi Arabia. A cross-sectional observational study was conducted among the caregivers of children aged 6-12 years in all Saudi Arabia regions. The data were gathered through a self-administered online questionnaire. It included demographic information, weight and height, and associated comorbidities, in addition to the weekly frequencies of snoring symptoms and of enuresis, as well as of unrefreshing sleep using Likert-type response scales. Counts and percentages, the mean ± standard deviation, chi-square test, independent samples t-test, and regression analysis were used in the statistical analysis using R v 3.6.3. The questionnaire was completed by 686 respondents. Most respondents did not report any comorbidities in their children (77.1%). Asthma and adenotonsillar hypertrophy were reported in 16.2% and 15.6% of children, respectively. Unrefreshing sleep, mouth breathing at night, snoring, chronic nasal obstruction, and difficulty breathing while asleep were reported once or twice per week in 38%, 34%, 28%, 18%, and 18% of children, respectively. The prevalence of NE was 22.3%, with about 36.6% of children having NE two or more times per week. Significantly, NE was reported in 26.6% of children who slept before 10 PM compared to 19% of children who slept after 10 PM; in 28.6% of children who snored or loudly snored (57.1%) three times or more per week; and in 51.2% and 27.5% of children with difficulty breathing while asleep and who breathed through their mouth at night for one or two nights per week, respectively. A multivariable regression analysis showed that male gender (OR = 1.52, p = 0.010), obesity (OR = 1.24, p = 0.028), early sleeping time (OR = 1.40, p = 0.048), loud snoring for three or more nights per week (OR = 1.54, p = 0.001), difficulty breathing for one or two nights per week (OR = 1.85, p = 0.010), and mouth breathing at night for one or two nights per week (OR = 1.55, p = 0.049) were associated with higher odds of NE. Our study revealed that 22.3% of primary school children reported suffering from NE. SDB is a common problem among children with NE. The exact mechanism that links SDB to the increase in the risk of NE is unknown. Male gender, obesity, early sleeping time, loud snoring, difficulty breathing, and mouth breathing at night are potential independent risk factors of NE in school-age children.
Collapse
Affiliation(s)
- Ali Abdullah Alshehri
- Department of Surgery, College of Medicine, Najran University, P.O. Box 1988, Najran 11001, Saudi Arabia
| | | | - Sameh Osama Nour
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo 11651, Egypt
| | - Wala H Gadi
- College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Basem A Zogel
- College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Samar M Alfaifi
- College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Enas M Masmali
- College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Amani B Aburasain
- College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia
| | - Mohamed Osama Nour
- Department of Public Health and Community Medicine, Damietta Faculty of Medicine, Al-Azhar University, Damietta 34511, Egypt
- Faculty of Public Health and Health Informatics, Umm Al-Qura University, P.O. Box 715, Makkah 21955, Saudi Arabia
| |
Collapse
|
5
|
Wen JG. Editorial comment on "epilepsy and frequent nocturnal enuresis among children in shanghai, China". J Pediatr Urol 2023; 19:21-22. [PMID: 36564286 DOI: 10.1016/j.jpurol.2022.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Jian Guo Wen
- Pediatric Urodynamic Center, Department Urology, First Affiliated Hospital of Zhengzhou University, China.
| |
Collapse
|
6
|
Karaaslan Y, Karaaslan U, Celenay ST. A comparison of lumbopelvic muscle endurance, stability, mobility, and respiratory functions in children and adolescents with and without nocturnal enuresis. Clin Biomech (Bristol, Avon) 2023; 101:105829. [PMID: 36481745 DOI: 10.1016/j.clinbiomech.2022.105829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Postural deterioration, delayed maturation, and accompanying respiratory diseases in children and adolescents with nocturnal enuresis have been reported in previous studies. This study aimed to compare lumbopelvic muscle endurance, stability, mobility, and respiratory functions in children and adolescents with and without nocturnal enuresis. METHODS Children and adolescents with (n:25, nocturnal enuresis group) and without nocturnal enuresis (n:29, control group) were included. The bladder and bowel dysfunctions with the Bladder and Bowel Dysfunction Questionnaire and voiding diary, lumbopelvic muscle endurance with the McGill trunk muscle endurance tests, lumbopelvic stability with the Sahrmann test, lumbopelvic mobility with the Modified Schober test, and respiratory function with a spirometer were assessed. Independent samples t-test, Mann Whitney U test, and Chi-square tests were used for analysis. FINDINGS Trunk flexor (p = 0.043), extension (p = 0.045), and right (p = 0.008) and left lateral flexion endurance test scores (sec) (p = 0.005), the Sahrmann test score (p = 0.005), and Modified Schober test (p < 0.001) results were lower in the nocturnal enuresis group compared to the control group. However, there were no differences between groups in terms of forced expiratory volume in 1 s (p = 0.415), forced vital capacity (p = 0.522), forced expiratory volume in 1 s/ forced vital capacity (p = 0.970), and peak expiratory flow values (p = 0.495). INTERPRETATION The children and adolescents with nocturnal enuresis had lower lumbopelvic muscle endurance, stability, and mobility compared to those without nocturnal enuresis; however, the respiratory functions were similar. The lumbopelvic structure changes may be taken into consideration for the management of nocturnal enuresis.
Collapse
Affiliation(s)
- Yasemin Karaaslan
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Hatay Mustafa Kemal University, Hatay, Turkey.
| | - Umut Karaaslan
- Department of Child and Adolescent Psychiatry, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey
| | - Seyda Toprak Celenay
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Ankara Yildirim Beyazit University Ankara, Turkey
| |
Collapse
|
7
|
Zhong S, Zhang L, Wang M, Shen J, Mao Y, Du X, Ma J. Abnormal resting-state functional connectivity of hippocampal subregions in children with primary nocturnal enuresis. Front Psychiatry 2022; 13:966362. [PMID: 36072465 PMCID: PMC9441761 DOI: 10.3389/fpsyt.2022.966362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Previous neuroimaging studies have shown abnormal brain-bladder control network in children with primary nocturnal enuresis (PNE). The hippocampus, which has long been considered to be an important nerve center for memory and emotion, has also been confirmed to be activating during micturition in several human imaging studies. However, few studies have explored hippocampus-related functional networks of PNE in children. In this study, the whole resting-state functional connectivity (RSFC) of hippocampus was investigated in children with PNE. Methods Functional magnetic resonance imaging data of 30 children with PNE and 29 matched healthy controls (HCs) were analyzed in our study. We used the seed-based RSFC method to evaluate the functional connectivity of hippocampal subregions defined according to the Human Brainnetome Atlas. Correlation analyses were also processed to investigate their relationship with disease duration time, bed-wetting frequency, and bladder volume. Results Compared with HCs, children with PNE showed abnormal RSFC of the left rostral hippocampus (rHipp) with right fusiform gyrus, right Rolandic operculum, left inferior parietal lobule, and right precentral gyrus, respectively. Moreover, decreased RSFC of the left caudal hippocampus (cHipp) with right fusiform gyrus and right supplementary motor area was discovered in the PNE group. There were no significant results in the right rHipp and cHipp seeds after multiple comparison corrections. In addition, disease duration time was negatively correlated with RSFC of the left rHipp with right Rolandic operculum (r = -0.386, p = 0.035, uncorrected) and the left cHipp with right fusiform gyrus (r = -0.483, p = 0.007, uncorrected) in the PNE group, respectively. In the Receiver Operating Characteristic (ROC) analysis, all the above results of RSFC achieved significant performance. Conclusions To our knowledge, this is the first attempt to examine the RSFC patterns of hippocampal subregions in children with PNE. These findings indicated that children with PNE have potential dysfunctions in the limbic network, sensorimotor network, default mode network, and frontoparietal network. These networks may become less efficient with disease duration time, inducing impairments in brain-bladder control, cognition, memory, and emotion. Further prospective research with dynamic observation of brain imaging, bladder function, cognition, memory, and emotion is warranted.
Collapse
Affiliation(s)
- Shaogen Zhong
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lichi Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Mengxing Wang
- College of Medical Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Jiayao Shen
- Department of Nephrology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Mao
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoxia Du
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Jun Ma
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
8
|
Li W, Yang G, Tian W, Li Y, Zhang L, Wang Y, Hong Y. Bibliometric and visual analysis of nocturnal enuresis from 1982 to 2022. Front Pediatr 2022; 10:972751. [PMID: 36034562 PMCID: PMC9412014 DOI: 10.3389/fped.2022.972751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 07/27/2022] [Indexed: 01/12/2023] Open
Abstract
Nocturnal enuresis is a common disorder among children that seriously affects physical and mental health and has become a social problem. Bibliometric analysis is a valid way to examine existing research results, current research hotspots and research frontiers. Current studies on nocturnal enuresis are numerous and complex, but a bibliometric analysis of the existing research on nocturnal enuresis has yet to be published. To better identify the research trends and frontiers in nocturnal enuresis, it is necessary to conduct a comprehensive review and analysis. We used bibliometric and visualization methods to analyze the 1,111 papers published between 1982 and 2022 from the Web of Science core collection. Basic information about the country, institution, and authors was analyzed, which led to a basic understanding of nocturnal enuresis. The United States is the most prolific country, Ghent University is the most influential institution, and Rittig Soren is the most prominent scholar. The frequency of keywords, clustering, and the cited literature were analyzed to understand the hotspots and frontiers of research, and a brief review of the highly cited literature was conducted. The current research hotspots are the treatment modalities for nocturnal enuresis, epidemiological investigations, and the exploration of pathogenesis. Clinical research, adenoidectomy, aquaporin 2, and response inhibition are potential research hotspots. The standardization of terminology in nocturnal enuresis and the pathologies of polyuria and sleep disorder are at the forefront of research. In summary, the results of our bibliometric analysis reveal views on the current situation and the trend of nocturnal enuresis research for the first time. This study may provide guidance for promoting research on nocturnal enuresis.
Collapse
Affiliation(s)
- Wenjie Li
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guang Yang
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenxiu Tian
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yunqi Li
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Zhang
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Youjie Wang
- Engineering Research Center of Modern Preparation Technology of Traditional Chinese Medicine of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanlong Hong
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|