Editorial
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Urol. Nov 24, 2016; 5(3): 90-92
Published online Nov 24, 2016. doi: 10.5410/wjcu.v5.i3.90
Enuresis and sleep disordered breathing: An old and new link
Marco Zaffanello
Marco Zaffanello, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Division of Pediatric, University of Verona, 37134 Verona, Italy
Author contributions: Zaffanello M solely finished this manuscript.
Conflict-of-interest statement: None declared.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Marco Zaffanello, MD, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Division of Pediatric, University of Verona, Piazzale L.A. Scuro, 10, 37134 Verona, Italy. marco.zaffanello@univr.it
Telephone: +39-45-8124381 Fax: +39-45-8124790
Received: April 5, 2016
Peer-review started: April 8, 2016
First decision: May 19, 2106
Revised: July 30, 2016
Accepted: August 30, 2016
Article in press: August 31, 2016
Published online: November 24, 2016
Processing time: 230 Days and 21 Hours
Abstract

The causes of nocturnal enuresis (NE) are likely multifactorial. It has been related to several (urological-nephrological-hormonal) reasons but clear and univocal pathogenesis remains mostly undetermined. Sleep disordered breathing (SDB) is a syndrome of upper airway dysfunction that occurs during sleep and is characterized by snoring and/or increased respiratory effort secondary to increased upper airway resistance and pharyngeal collapsibility. Adenotonsillar hypertrophy is the main cause of SDB in children. To date, several studies have associated childhood NE with coexistent SDB. Adenotonsillectomy was successful for both SDB and NE in about half of patients. Unfortunately, practical consensus guidelines for the management of primary NE do not mention, or marginally concern, SDB in these children, particularly in those who have treatment resistance and comorbidities. The concerns regard the concomitant presence of two relatively frequent sleep disorders, raising the question whether they are really coincidental problems of childhood.

Keywords: Children; Sleep disordered breathing; Enuresis

Core tip: Several studies have pointed out the high frequency of sleep disordered breathing (SDB) in children with nocturnal enuresis (NE), particularly refractory (medication resistant) or secondary. Practical consensus guidelines for NE, corroborated by recent investigation of the topics, need to be revisited considering the high recurrence of SDB in childhood NE and a high success rate of intervention for it.