the effect of adenotonsillectomy on pediatric nocturnal enuresis: a prospective cohort study

introduction: sleep disorder caused by adenotonsillar hypertrophy has been implicated as a cause of primary and secondary nocturnal enuresis in children.  this study was conducted to investigate the effect of adenotonsillectomy on enuresis in children with adenotonsillar hypertrophy.  materials and methods: this prospective cohort study was conducted in hamadan city in western iran, from april 2010 to december 2011. ninety-seven children aged 3 to 12 years with adenotonsillar hypertrophy who were admitted to besat hospital for adenotonsillectomy were evaluated. the primary outcome was the number of incidents of bedwetting (nocturnal enuresis) post-operation compared with pre-operation. patients were followed-up for 3 months. data were collected using a questionnaire regarding number of bedwetting incidents, type of enuresis (primary or secondary), and family history of enuresis, as well as results of urine analysis.  results: of 420 children admitted for adenotonsillectomy, 97 had a positive history of preoperative enuresis, including 42 girls and 55 boys, with mean age of 48 months. the parents of 84 (86.6%) children agreed to participate in the study. three months after adenotonsillectomy, enuresis had resolved completely in 51 (60.7%) children and had shown relative improvement in 22 (26.2%) children. enuresis had not improved in the remaining 11 (13.1%) children (p<0.001).  conclusion:  the results of this study indicate that adenotonsillectomy can improve enuresis in the majority of children with adenotonsillar hypertrophy. however, further evidence based on large multi-center randomized clinical trials is required to confirm these results.