Effectiveness of adenotonsillectomy in the resolution of nocturnal enuresis secondary to obstructive sleep apnea.
OBJECTIVE
To investigate the relationship between obstructive sleep apnea (OSA) syndrome and nocturnal enuresis (NE) in patients who required tonsillectomy or adenoidectomy.


METHODS
Retrospective chart review with prospective collection of data.


METHODS
All charts of patients ages 2 to 18 years that had tonsillectomy or adenoidectomy over a 44 month period were reviewed for presence of NE and indication for surgery. Those patients with a positive history of both NE and OSA were surveyed to determine whether there was no change in enuresis, decreased enuresis, or no enuresis postoperatively.


RESULTS
Three hundred twenty-six children who had undergone tonsillectomy or adenotonsillectomy had data regarding enuresis available in their charts. One hundred seven of these 326 (32.8%) children had a positive history of enuresis. Of the 107 children with a positive history, 44 (41.1%) were female, and 63 (58.9%) were male. All 107 children with enuresis underwent adenotonsillectomy for OSA. None of the children who had a history of recurrent adenotonsillitis or chronic tonsillitis reported enuresis as a presenting symptom. Of the 107 children with a positive preoperative history of NE, 57 (53.3%) agreed to participate in the second phase of the study. Postoperatively, 61.4% (35) of the children were free of enuresis, 22.8% (13) had a decrease in enuresis, and 15.8% (9) had no change in enuresis. A chi-square test showed a statistically significant difference among the groups (P < .0001).


CONCLUSIONS
NE is a relatively common finding in children with OSA symptoms. NE resolves or markedly improves in the vast majority of these patients postoperatively.
Basha
Suzanne
S
Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania 19140, USA.
Bialowas
Christie
C
Ende
Kevin
K
Szeremeta
Wasyl
W
D000233:Adenoidectomy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004775:Enuresis / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000601:surgery*; D014068:Tonsillectomy