Surgical resection of the tissue of the tonsils and adenoid growths is a frequent surgical intervention that is prescribed for children with chronic and recurrent tonsillitis and pharyngitis. Sometimes the operation is accompanied by the removal of adenoid tissues. Scientists have noticed that adenotonsillectomy, which was performed on children suffering from obstructive sleep apnea, contributed to the reduction of episodic nocturnal enuresis.
The results of the research work were published by the specialists on the pages of the JAMA Otolaryngology Head&Neck Surgery publication .
Scientists have long proven the existence of a relationship between nocturnal enuresis and sleep apnea disease - a condition in which respiratory activity is suddenly interrupted during sleep, abruptly resuming after a short break. Bedwetting is diagnosed in almost half of children with this syndrome. It has been established that the cause of the pathology is often associated with a hypertrophic increase in the lymphoid-epithelial pharyngeal ring - a large accumulation of lymphoid tissue in the mucous membranes of the upper respiratory system. The apparatus is represented by the pharyngeal, lingual, laryngeal, tubal and palatine tonsils, as well as single follicles located in the mucous tissues of the pharynx and oropharynx. The researchers set out to test whether neutralizing the cause of the obstructive disorder could have an impact on episodic bedwetting.
About four hundred children suffering from mild sleep apnea were involved in the study . The average age of the participants was 6-7 years (in general - from 5 to 9 years). The children were divided into two groups. The first included small patients who underwent adenotonsillectomy. The second group included children who were subjected to observation and careful medical monitoring. The study continued for more than six months. After about seven months, the scientists summed up and noted that in the second observed group, the frequency of bedwetting was approximately twice the number that was in the group of children who underwent adenotonsillectomy. At the same time, the researchers indicated an 11% reduction in the incidence of episodic enuresis in patients after tonsil resection.
In the explanatory information to the research work, it is indicated that bedwetting was more often diagnosed in girls. Attention was also paid to age characteristics, racial and ethnic origin of the subjects, tendency to obesity, hypopnea/apnea ratio. The existence of a connection between these factors and the improvement in the well-being of children has not been proven.
As the team of researchers explained, the results of their work are indeed very important. Children suffering from nocturnal urinary incontinence should be examined by a pediatric otorhinolaryngologist. It is important to timely assess the presence of clinical indications for adenotonsillectomy.