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SHOULD ENURETIC CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY
DISORDER (ADHD) BE TREATED DIFFERENTLY?
Larisa KOVACEVIC, Cortney WOLFE-CHRISTENSEN, Hong LU and Yegappan LAKSHMANAN
Children's Hospital of Michigan, Pediatric Urology, Detroit, USA
PURPOSE
We aimed to study (1) whether children with ADHD exhibited greater severity of enuresis and associated symptoms as
compared to age- and gender-matched children without ADHD, and (2) whether children with ADHD were more resistant
to treatment than controls.
MATERIAL AND METHODS
Retrospective data review of all children seen with nocturnal enuresis (NE) and ADHD (study group) and age- and
gender-matched children with NE without ADHD (control group) between 2010-2014. Presenting voiding complaints
(number of weekly wet days and/or nights, daily voids, urgency), and the Bristol and Dysfunctional Voiding Symptom
(DVSS) scores were compared between study and control groups before and after the initiation of enuresis treatment
(ANOVA).
RESULTS
Each group consisted of 95 children (67 boys), age range 5-16 years.
Study patients had significantly more severe nocturnal enuresis (p=0.047), associated diurnal incontinence (47.9% vs
28.4%, p=0.006), DVSS score (11.53 +/- 4.53 vs 9.84 +/- 3.82, p=0.008), and Bristol score (2.92 +/- 0.95 vs 3.23
+/- 0.87, p=0.02) than controls. Thirty-four study children and 26 controls were treated with behavioral modification
and showed similar response (14.7% vs 19.2% , p=0.73). Nineteen patients and 27 controls received pharmacological
treatment for NE. Response to treatment was seen in 9 (47.4%) and 6 (22.2%) respectively, with no significant
statistical difference.
CONCLUSIONS
Children with ADHD had more severe voiding dysfunction and bedwetting than those without ADHD. However, the
presence of ADHD did not affect the response to treatment of NE. Similar treatment strategies could be used in enuretic
children with and without ADHD.