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Journal of the Korean Society of Pediatric Nephrology 2000;4(1): 69-76.
일차성 야뇨증의 위험 요인
이수진, 양정안, 유은선, 서정완, 이승주
1이화여자대학교 의과대학 소아과학교실, 의과학 연구소
2이화여자대학교 의과대학 소아과학교실, 의과학 연구소
3이화여자대학교 의과대학 소아과학교실, 의과학 연구소
4이화여자대학교 의과대학 소아과학교실, 의과학 연구소
5이화여자대학교 의과대학 소아과학교실, 의과학 연구소
Risk Factors of Primary Nocturnal Enuresis
Soo-Jin Lee, Jung-An Yang, Eun-Sun Yoo, Jang-Wan Seo, Seung-Joo Lee
1Department of Pediatrics, Ewha Womans University, College of Medicine
2Department of Pediatrics, Ewha Womans University, College of Medicine
3Department of Pediatrics, Ewha Womans University, College of Medicine
4Department of Pediatrics, Ewha Womans University, College of Medicine
5Department of Pediatrics, Ewha Womans University, College of Medicine
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ABSTRACT
Purpose: The Pathogenesis of primary noctllrnal enuresis(PNE) is still controversial. Genetic factor and maturational delay of micturition reflex including arousal disorder, lack of nocturnal Arginine Vasopressin(AVP) release and functional bladder capacity have been suggested. We analyzed the risk factors of PNE.
Methods: Fifty five children with PNE (20 enuretics diagnosed at school physical examination of the first grade students at Mok-Dong Elementary School and 35 enuretics (Age 6-7 year) diagnosed at Ewha Womans University Mok Dong Hospital) and 221 control students without PNE at school physical examination were included. Genetic, stress and developmental factors, arousability, water intake, urine volume, maximun voiding volume and daytime voiding dysfunction were compared.
Results : 1) There was no significant difference between PNE and control group in sex ratio, birth order, percentage of working mothers, parental and child personality, age to start walking, school record and duration of sleep. 2) Family history in the PNE group was significantly higher than control group ($20.0%;vs;2.7%$)(P<0.05). 3) The difficulty in arousal in the PNE group was significantly more common than the control group ($70.9%;vs;54.3%$)(P<0.05). 4) Nocturnal water intake in the PNE group was significantly greater than the control group ($330{pm}158.2;mL;vs;235{pm}129.5;mL$). Nocturnal urine volume in the PNE group was significantly greater than the control group ( $390{pm}61.5;mL;vs;140{pm}43.2;mL$)(P<0.05). Daily water intake and daily urine volume did not significantly differ between the two groups. 5) Maximum urine volume per void in the PNE group was significantly lower than the control group ($107{pm}35.9;mL;vs;236{pm}41.3;mL$). Daytime voiding dysfunction in the PNE group was significantly more common than the control group ($80.0%;vs;57.9%$). The voiding frequency in the PNE group was significantly greater than the control group ($7.0{pm}3.6;vs;5.4{pm}1.6$)(P<0.05).
Conclusion : In addition to genetic factors and maturational delay of micturition reflex (difficulty in arousal, nocturnal polyuria and decreased functional bladder capacity) nocturnal polydypsia was found to be the important risk factors fur PNE. So nocturnal fluid restriction should be encouraged as the first-line management of PNE.
Key words: Primary nocturnal enuresis | Nocturnal Polyuria | Nocturnal Polydypsia Functional Bladder Capacity
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