Published: 2019-12-23

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

Zephania S. Abraham, Aveline A. Kahinga, Kassim B. Mapondella, Enica R. Massawe, Emmanuel Ole Lengine, Daudi Ntunaguzi


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.



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

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