title: Adenotonsilectomy improves enuresis in children with obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  To evaluate the prevalence of nocturnal enuresis (NE) in children diagnosed with obstructive sleep apnea syndrome (OSAS) and the effect of tonsillectomy and adenoidectomy on enuresis.
  
  
  METHODS
  All children 4-18 years of age who underwent polysomnography (PSG) between January 2003 and May 2004 were included (n=161). The evaluation was based on a retrospective review of a standard sleep questionnaire and a full overnight PSG, followed by an additional structured telephone questionnaire performed 9 months after adenotonsillectomy (T&A) (range 5-14).
  
  
  RESULTS
  We identified 144 (89%) children with an apnea hypopnea index >1. Of these 144 children, 42 [29.2% (95% CI, 21.8-36.6)] were reported to have enuresis, 27 of these 42 underwent T&A. Among the 27 enuretic children who had undergone adenotonsillectomy, 74.1% had 3 or more wet nights per week before the procedure compared to 37%, 1 month after [n=27 (chi2=3.308, McNemar pv<0.0001)]. Of the 27 children who underwent adenotonsillectomy, any decrease in enuresis severity was reported by 70.4% (95% CI 53.2-87.62), while in 56% of these 27 (95% CI 41.96-70.06) it occurred 1 month postoperatively. In 11/27 children (41%), enuresis totally disappeared within 1 month, while in 3/27 (11%) enuresis disappeared throughout the remaining time of follow-up.
  
  
  CONCLUSIONS
  Obstructive sleep apnea in children is frequently associated with nocturnal enuresis. Adenotonsillectomy has a favorable therapeutic effect on enuresis in children with obstructive sleep apnea presenting this symptom.
authors.affiliation: Department of Pediatrics B, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Avichai
authors.initials: A
authors.lastname: Weissbach
authors.forename: Alberto
authors.initials: A
authors.lastname: Leiberman
authors.forename: Ariel
authors.initials: A
authors.lastname: Tarasiuk
authors.forename: Aviv
authors.initials: A
authors.lastname: Goldbart
authors.forename: Asher
authors.initials: A
authors.lastname: Tal
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004775:Enuresis / Q000150:complications / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017286:Polysomnography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000601:surgery*; D011795:Surveys and Questionnaires; D014068:Tonsillectomy