Effect of Adenotonsillectomy on Nocturnal Enuresis in Children with Obstructive Sleeping Apnea

Ramla Dahir Hersi, Resident of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Mansoura University, EgyptFollow
Hossam El-sayed Elsisi, Professor of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Mansoura University, Egypt
Ahmed Abdoo Elzehzahy, lecturer of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Mansoura University, Egypt

Subject Area

Otolaryngology

Article Type

Original Study

Abstract

Background: Nocturnal enuresis (NE) is the involuntary passage of urine during sleep and is a common condition in the pediatric population. Obstructive sleep apnea (OSA), characterized by recurrent episodes of upper airway obstruction during sleep, has increasingly been identified as a significant contributing factor to NE. Previous studies indicate that children with OSA have a higher prevalence of bedwetting than their healthy counterparts.

Objective: To assess the impact of adenotonsillectomy (AT) on NE in children diagnosed with obstructive sleep apnea.

Methods: This prospective study enrolled 20 pediatric patients presenting with both NE and OSA secondary to severe adenotonsillar hypertrophy. Tonsillar enlargement was clinically evaluated using the Brodsky grading scale. OSA symptoms were assessed with a validated sleep questionnaire, and NE was diagnosed using criteria established by the International Children’s Continence Society. Postoperative evaluations were performed at one week, three months, and six months after surgical intervention.

Results: At the 3-month follow-up, 45% of children showed improvement in enuresis, although this change was not statistically significant. By 6 months, enuresis had recurred in 7 children. The frequency of wet nights decreased significantly at 3 months and increased slightly at 6 months, remaining improved compared with baseline. In contrast, daytime sleepiness, difficulty awakening, urinary frequency, and urgency showed sustained improvement throughout follow-up. Total snoring questionnaire scores decreased significantly at 6 months, reflecting an overall improvement of 69.2%.

Conclusion: Adenotonsillectomy appears to contribute to meaningful improvement in nocturnal enuresis in a substantial proportion of children with coexisting OSA and NE

Recommended Citation

Hersi, Ramla Dahir; Elsisi, Hossam El-sayed; and Elzehzahy, Ahmed Abdoo (2026) "Effect of Adenotonsillectomy on Nocturnal Enuresis in Children with Obstructive Sleeping Apnea," Mansoura Medical Journal: Vol. 55 : Iss. 5 , Article 7.
Available at: https://doi.org/10.58775/2735-3990.1565