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http://www.medscape.com/viewarticle/443529?mpid=5385

BOSTON (Reuters Health) Oct 23 - Children with attention deficit-hyperactivity disorder are prone to nocturnal enuresis as well as other urinary tract and bowel problems, according to results of a study presented this week during the American Academy of Pediatrics National Conference.

"This is the first study to prove that dysfunctional voiding is a significant comorbidity of ADHD," lead investigator Dr. Barry P. Duel of the University of California Irvine told Reuters Health.

In a case-control survey of 28 children with "rigorously-diagnosed" ADHD and 23 age- and sex-matched controls without ADHD, Dr. Duel said they found "statistically significant differences" in responses to 10 questions about urination and bowel problems.

The children with ADHD were between two and three times more likely to report nocturnal enuresis, dysuria, incontinence, urgency, infrequent voiding and constipation than control children.

"We as pediatric urologists and pediatricians had the suspicion that children with ADHD had a lot more problems with bedwetting and daytime incontinence, but no study ever specifically addressed it," Dr. Duel said.

He also presented results indicating that computerized biofeedback results in decreased bladder and bowel problems.

In the study, all 48 children, whose average age was 8, completed at least four biofeedback sessions. "During these sessions, electrodes are placed on the perineum and abdomen, and the child is basically trained to urinate properly," Dr. Duel said. "It teaches them to isolate and recognize the muscles relaxing."

Biofeedback reduced daytime incontinence and nocturnal enuresis by about 54% and 42%, respectively. The researchers also saw significant declines in urinary tract infections, encopresis, and constipation.

"This study adds to the literature that biofeedback should be the accepted treatment for bedwetting and daytime incontinence," Dr. Duel said. Importantly, he said, "biofeedback is a benign treatment, one that is very acceptable to children."

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