Lower urinary tract dysfunction in children with attention deficit hyperactivity disorders

Goal: the aim of this work was to identify the various types of lower urinary tract dysfunctions (LUTD among children with Attention Deficit Hyperactivity Disorders (ADHD) and their responses to treatments. Methods: this prospective work had been conducted on participants aged 6 -18 years old, who fulfilled criteria for ADHD with any type of LUTD and only naive patients who had no previous urological treatment. All patients were subjected to the standard psychiatric treatment in form of Atomoxetine and/or methylphenidate. The patients were re-evaluated at 1,3,6 months to assess improvement of daytime symptoms and nocturnal enuresis (NE). Results: in our 60 patients, there was no significant different between recurrence rate of NE and type of ADHD and NE. There was no significant different between type of ADHD according to response of enuresis treatment. Regarding response of treatment of daytime symptoms, 14 (77.7 %) patients showed full response, while 4 (22.2 %) patients did not show response. In patients with NE, 28 (66.7 %) patients showed full response, 8 (19.0 %) patients showed intermediate response, and 6 (14.3 %) patients did not show response. While in patients with non- monosymptomatic NE, 14 (77.8 %) Patients with showed full response, while 4(22.2 %) did not show response. Conclusions: a combination therapy of desmopressin and imipramine is efficient treatment of monosymptomatic NE in ADHD children, while anticholinergic drugs plus desmopressin are effective in non-monosymptomtic NE. Limitations: number of cases is small and further multicenter studies are needed to confirm our conclusion. Originality: this manuscript describes an original work.