Long-term results of systematic treatment for nocturnal enuresis based on overnight simultaneous monitoring of electroencephalography and cystometry

Abstract

(Background) The long-term results of systematic treatment based on overnight simultaneous monitoring of electroencephalography (EEG) and cystometry in the patients with enuresis were evaluated. (Methods) From January to December, a total of 213 patients were classified into 3 types. Enuresis Type IIa; such cases show a normal CMG without an awakening response on the EEG. Enuresis Type IIb; such cases show an abnormal CMG with no awakening response on the EEG. When such cases enter the deep sleep stage, continuous uninhibited contractions of the bladder are observed on the CMG. 136 cases were of Type I, 20 cases of Type IIa, and 57 cases of Type IIb. (Results) Out of 213 patients who were followed up for 2 years, cured cases were 94 (44%), effective cases were 81 (38%) and unchanged cases were 38 (18%). In 136 patients with Type I, cured cases were 71 (52%), effective cases were 50 (37%) and unchanged cases were 15 (11%). In 20 patients with Type IIa, cured cases were 8 (40%), effective cases were 9 (45%) and unchanged cases were 3 (15%). In 57 patients with Type IIb, cured cases were 15 (26%), effective cases were 22 (39%) and unchanged cases were 20 (35%). The age of the effective group, which included cured cases and effective cases, was significantly higher than that of the unchanged group. In enuresis Type I, the percentage of the patients with incontinence in daytime were significantly in the unchanged group than in the effective group. No significant differences in the frequency of enuresis and the percentage of the patients who had awakened spontaneously by urinary sensation were found between the two groups. (Conclusions) The therapeutic response was best in enuresis Type I and worst in enuresis Type IIb. The patients in whom not only frequency of enuresis but also type of enuresis was unchanged by systematic treatment for two years, was approximately 10% across the types. Accordingly they were thought to be non-responders to this systematic treatment.