Somatic correlates of functional enuresis

Functional enuresis is a heterogeneous group of syndromes with different ae tiology and pathophysiology. The aim was to identify specific somatic corre lates of enuresis non-invasively in child psychiatric patients after exclus ion of neurologic and structural forms of incontinence. One hundred sixty-s even consecutive children, aged 5 to 10 years with day and/or night wetting were examined prospectively with: urinalysis and bacteriology; ultrasonogr aphy, including bladder wall thickness and residual volume; uroflowmetry an d pelvic-floor-EMG; EEG; and a complete paediatric-neurologic examination. Day wetting children had a significantly higher rate of previous antibiotic prophylaxis, larger residual volume, thicker bladder walls; the uroflow cu rves were significantly less bell- and more staccato-shaped, the EMG less r elaxed. Voiding postponers showed a tendency towards more uroflow anomalies than urge incontinent children. Primary and secondary enuretics did not di ffer on most parameters, but primary nocturnal enuretics with micturition p roblems had significantly less relaxed EMGs than monosymptomatic enuretics. Although day wetters had more pathological EEGs and neurological signs, th ese differences did not reach significance. The overall rate of urogenital anomalies was 10%. In conclusion, enuresis has a high rate functional somat ic correlates with clinical and theoretical, classificatory implications.