title: Etiology and pathology of enuresis among primary school children in Isfahan, Iran.
abstract: OBJECTIVE
  To determine the etiology and pathogenesis of enuresis among primary school children by using a special ultrasound (US) protocol for the assessment of bladder dysfunction and to compare excretion of urinary sodium and calcium in enuretic children.
  
  
  METHODS
  We conducted this cross sectional study on 66 enuretic children aged 6-12 years from September 2005 to January 2006 in Isfahan University of Medical Sciences, Iran. Ultrasound (US) was designed for the evaluation of bladder parameters using bladder volume and wall thickness index (BVWI%), and expected percentage bladder volume index for kidney volume.
  
  
  RESULTS
  Sixty children (90.9%) had nocturnal enuresis, 5 (7.5%) had diurnal enuresis and one child (1.6%) had nocturnal and diurnal enuresis. Urinary infection was detected in one child (1.5%). The incidence of urinary system abnormalities was 10.6% in all enuretic children. Hypercalciuria was seen in 9.2% and natriuresis in 20.3%. Normal bladder function (BVWI 70% to <130%) was seen in 67%, small bladder with a thick wall (BVWI <70%) in 27% and large bladder capacity with a thin wall (BVWI >130%) was seen in 6% of children with primary nocturnal enuresis (PNE). There was a significant difference in BVWI between children with PNE and secondary nocturnal enuresis (p=0.01).
  
  
  CONCLUSIONS
  Enuresis is a common problem among school children and associated urinary abnormalities are not uncommon. Our results show that US measured bladder parameters can provide useful clues for the underlying bladder dysfunction and may help to guide clinical management.
authors.affiliation: Department of Pediatrics, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. azhir@med.mui.ac.ir
authors.forename: Afshin
authors.initials: A
authors.lastname: Azhir
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Nasseri
authors.forename: Aliyar
authors.initials: A
authors.lastname: Fazel
authors.forename: Atoosa
authors.initials: A
authors.lastname: Adibi
authors.forename: Ziba
authors.initials: Z
authors.lastname: Frajzadegan
authors.forename: Abol-Hassan
authors.initials: AH
authors.lastname: Divband
mesh_terms: D002118:Calcium / Q000652:urine; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D004775:Enuresis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012964:Sodium / Q000652:urine; D014463:Ultrasonography
chemical_list: D012964:Sodium; D002118:Calcium