title: Spina bifida occulta: not to be overlooked in children with nocturnal enuresis.
abstract: OBJECTIVE
  Previous reports have suggested that the incidence of spina bifida occulta in patients with nocturnal enuresis is higher than in the general population. However, the effect of spina bifida occulta on the response to nocturnal enuresis treatment is controversial. The purpose of this study was to investigate the relationship between spina bifida occulta and response to treatment of nocturnal enuresis.
  
  
  METHODS
  Between 2006 and 2009, the records of 160 children with nocturnal enuresis were reviewed. Children with other organic urological disease or symptoms suggestive of spinal dysraphism were excluded. Plain radiography for the kidney-ureter-bladder was carried out before the start of the nocturnal enuresis treatment. Response to treatment of children with and without spina bifida occulta was compared.
  
  
  RESULTS
  Of 160 children, 53 were girls; the mean age was 7.8 ± 2.06 years. The mean duration of treatment was 8.7 ± 9.29 months. Spina bifida occulta was detected in 43 children (26.9%). Spina bifida occulta affected L4 in four children, L5 in 12 children, S1 in 26 children and S2 in one child. There was a significant difference between the spina bifida occulta and non-spina bifida occulta groups in terms of outcome (P=0.002), with a complete response more likely in children without spina bifida occulta (P=0.005). None of the children with primary non-mono symptomatic nocturnal enuresis and spina bifida occulta showed a complete response.
  
  
  CONCLUSIONS
  The presence of spina bifida occulta significantly affects the response to treatment in patients with nocturnal enuresis. Thus, verifying spina bifida occulta in this patient population can facilitate the prediction of the response to nocturnal enuresis treatment.
authors.affiliation: Bladder-Urethra Rehabilitation Clinic, Yonsei University Health System, Korea.
authors.forename: Sang Hee
authors.initials: SH
authors.lastname: Shin
authors.forename: Young Jae
authors.initials: YJ
authors.lastname: Im
authors.forename: Mi-Jung
authors.initials: MJ
authors.lastname: Lee
authors.forename: Yong Seung
authors.initials: YS
authors.lastname: Lee
authors.forename: Eun Kyoung
authors.initials: EK
authors.lastname: Choi
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Han
mesh_terms: D000293:Adolescent; D050034:Antidiuretic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D053206:Nocturnal Enuresis / Q000188:drug therapy* / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D016136:Spina Bifida Occulta / Q000000981:diagnostic imaging / Q000453:epidemiology*; D016896:Treatment Outcome
chemical_list: D050034:Antidiuretic Agents; D018680:Cholinergic Antagonists; D003894:Deamino Arginine Vasopressin
keywords: X-ray film; anticholinergics; desmopressin; nocturnal enuresis; spina bifida occulta