1977 Volume 68 Issue 7 Pages 636-643
Between Jul., 1973, when HYOGO Medical College was established, and Sep., 1975, 136 enuretic children (87 boys 49, girls) were referred to our department. The peak in age distribution of the enuretic was 5 to 6 years old, and the children older over 10 years old were less than 10 per cent. Through the urological and urodynamic examinations, the following results were obtained.
1) Pyuria was found in 41 per cent of the enuretic.
2) Although the incidence of abnormal IVP, such as inflammatory changes and/or dilatation of the collecting system, was low in this series, spina bifida occulta was observed at a rate of 53 per cent, Hutch's diverticula, 27 per cent and V-shaped break at bladder base, 22 per cent.
3) Of the 136, 94 were underwent micturating cystourethrography with/without bougie a boule caliblation, and 57 of them (61 per cent) demonstrated to have urethral stenosis, mainly Lyon's ring.
4) Only 66 children received simple filling cystometry, because of difficulty to obtain co-operation, and 43 of them (65 per cent) were proved to have hypertonicity with ‘uninhibited contraction’.
5) In conjunction with cystometry, sphincter electromyogram was recorded simultaneously. The electrical activities of the 43 enuretics showed normal patterns in 25, detrusor-sphincter dyssynergia in 7, and pathologicaly low or silent electrical activities in 11.
6) In the cases of organic urethral stenosis, the external urethral sphincter was proved to contract during urination and easily excitable to urethral or bulbacavexnous stimulation in more than half of them.
Although enuretic children tend to decrease in numbers with age, probably because of ‘maturation of bladder control’, the presence of latent organic urethral stenosis and/or subclinical neurogenic bladde dysfunction should be considered in relation to pathogenesis of enuresis.
