OBJECTIVE: Complicated @entity1494 ( @entity1494 ) (associated with @entity281 or irresponsive to treatment) are a small proportion of all cases, but are highly morbid, clinically and psychosocially. Our aim is to describe a cohort of complicated pediatric @entity1494 , using subgroup analysis to compare presentations and responses to treatment among genders, age groups, and @entity1 with or without non-monosymptomatic enuresis (NME). We also relate severe @entity1494 to other health conditions or to social/ @entity146 and report treatment results. METHOD: Thirty-five cases of complicated @entity1494 were reviewed. @entity1494 and anatomical urological problems were excluded. Justifications for referral, comorbidities, and social aspects/familial dynamics were studied. Overactive bladders were primarily treated with @entity11440 . Transcutaneous parasacral neuromodulation was used in case of insufficient response or unbearable side effects. For infrequent voiders, timed voiding and transcutaneous neuromodulation were counseled. RESULTS: Incontinence/enuresis were the motives for referral in only a third of the cases. UTI (42.9%) was the main reason for referral. @entity3041 was observed in 8.6% of the @entity1 . Respiratory/ENT problems, @entity28 , and precocious puberty were highly prevalent. Schooling problems and @entity146 were common. Social problems were common. Five @entity1 presented urological problems secondary to @entity1494 (hydroureteronephrosis, @entity3025 , @entity1494 ). Twenty percent of cases required high anticholinergic doses and 37.1% transcutaneous electrostimulation. Eight (22.9%) @entity1 abandoned but later resumed therapy, and 14.6% did not follow treatment. @entity1 tended to be older than @entity1 and presented NME, respiratory, and @entity146 more often, with a significant difference for @entity565 and @entity148 / @entity308 . Associated health problems and neuropsychiatric treatment tended to be more frequent among those presenting NME. Non-enuretic @entity1 tended to show better results from treatment (see Table). CONCLUSION: The social characteristics of our population (severe cases, socially deprived, very poor, not well educated, and with limited access to health care) determine a very specific sampling. Our research demonstrated that even severe cases of @entity1494 affecting socially deprived @entity1 may be treated, with adhesion to treatment and results comparable with other cohorts of @entity1494 , although the @entity1 need multidisciplinary attention and close follow-up. @entity1 , older @entity1 , and NME are more difficult to treat and often have other associated health and @entity146 . Stress-related conditions were common in severe @entity1494 . A relatively high occurrence of precocious puberty was an unexpected finding in our research.

Psychosocial and respiratory disease related to severe XXXX and non-monosymptomatic enuresis.

@entity1 :: ('9606', 'Species') :: ['children', 'Boys', 'patients', 'girls'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depression'] @entity1494 :: ('MESH:D001745', 'Disease') :: ['Neurogenic bladders', 'trabeculated bladder', 'BD', 'bladder dysfunctions'] @entity146 :: ('MESH:D001523', 'Disease') :: ['behavioral problems', 'neuropsychiatric disease'] @entity28 :: ('MESH:D009765', 'Disease') :: ['obesity'] @entity565 :: ('MESH:D001249', 'Disease') :: ['asthma'] @entity3041 :: ('MESH:D006869', 'Disease') :: ['Hydronephrosis'] @entity3025 :: ('MESH:D014718', 'Disease') :: ['VUR'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infections/urological complications'] @entity148 :: ('MESH:D001008', 'Disease') :: ['anxiety'] @entity11440 :: ('MESH:C005419', 'Chemical') :: ['oxybutynin']
@entity1494 :: (MESH:D001745,Disease) :: ['bladder dysfunction']
