Effectiveness of adenotonsillectomy in resolution of enuresis in children with sleep-disordered breathing: a hospital based prospective cohort study in Dar es Salaam, Tanzania

Authors

  • Zephania S. Abraham Department of Surgery, University of Dodoma, College of Health and Allied Sciences, Dodoma
  • Aveline A. Kahinga Department of Otorhinolaryngology, Muhimbili National Hospital, Dar es Salaam
  • Kassim B. Mapondella Department of Otorhinolaryngology, Muhimbili University of Health and Allied Sciences, Dar es Salaam
  • Enica R. Massawe Department of Otorhinolaryngology, Muhimbili University of Health and Allied Sciences, Dar es Salaam
  • Emmanuel Ole Lengine Department of Otorhinolaryngology, Ekenywa Specialised Hospital, Dar es Salaam
  • Daudi Ntunaguzi Department of Otorhinolaryngology, Muhimbili University of Health and Allied Sciences, Dar es Salaam

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20195707

Keywords:

Adenotonsillectomy, Enuresis, Nocturnal, Sleep-disordered breathing, Tanzania

Abstract

Background: Adenotonsillar hypertrophy remains to be the commonest causes of sleep disordered breathing in paediatric patients and has been implicated as a cause of primary and secondary enuresis. The aim of this study was to determine the effectiveness of adenotonsillectomy in resolution of enuresis in children with sleep-disordered breathing.

Methods: A hospital based prospective cohort study was conducted at Ekenywa Specialised Hospital in Dar es Salaam, from May 2018 to February 2019. Two hundred children aged 3 to 15 years with obstructive adenotonsillar hypertrophy who were admitted ready to undergo adenotonsillectomy were evaluated. Upon such evaluation, the primary outcome was the number of bedwetting incidents (nocturnal enuresis) post-operatively compared with pre-operative incidents. Patients were kept under follow-up for 3 months. Data were collected using structured questionnaires regarding number of bedwetting incidents, type of enuresis (primary or secondary) and family history of enuresis. Data was analyzed using SPSS version 21 and p-values <0.05 were considered to be statistically significant.  

Results: Of 200 children admitted for adenotonsillectomy, 80 (40%) had a positive history of preoperative enuresis, including 35 (43.8%) girls and 45 (56.2%) boys.  All parents for the children consented to participate in the study. Three months after adenotonsillectomy, enuresis had resolved completely in 50 (62.5%) children and had shown relative improvement in 25 (31.3%) children. Enuresis had not improved in the remaining 5 (6.3%) children (p<0.05).

Conclusions: Findings from this study indicates that adenotonsillectomy can improve nocturnal enuresis and day-time incontinence in the majority of children with adenotonsillar hypertrophy.

 

Author Biographies

Zephania S. Abraham, Department of Surgery, University of Dodoma, College of Health and Allied Sciences, Dodoma

Lecturer Department of Surgery

Aveline A. Kahinga, Department of Otorhinolaryngology, Muhimbili National Hospital, Dar es Salaam

ENT Surgeon

Department of Otorhinolaryngology
Muhimbili National Hospital

Kassim B. Mapondella, Department of Otorhinolaryngology, Muhimbili University of Health and Allied Sciences, Dar es Salaam

Lecturer,

Department of Otorhinolaryngology
Muhimbili University of Health and Allied Sciences-Tanzania

Enica R. Massawe, Department of Otorhinolaryngology, Muhimbili University of Health and Allied Sciences, Dar es Salaam

Lecturer

Department of Otorhinolaryngology
Muhimbili University of Health and Allied Sciences

Emmanuel Ole Lengine, Department of Otorhinolaryngology, Ekenywa Specialised Hospital, Dar es Salaam

Lecturer,

Department of Otorhinolaryngology,
Muhimbili University of Health and Allied Sciences

 

Daudi Ntunaguzi, Department of Otorhinolaryngology, Muhimbili University of Health and Allied Sciences, Dar es Salaam

Lecturer

Department of Otorhinolaryngology
Muhimbili University of Health and Allied Sciences

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Published

2019-12-23

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Section

Original Research Articles