Sevilay AYNACI, Deniz NAMIDURU
European Journal of Rhinology and Allergy - 2026;9(2):87-90
Objective: Primary enuresis is a common childhood condition with multifactorial causes, including genetic, neurological, and hormonal factors. Recent evidence suggests a possible link between upper airway obstruction (UAO), especially from adenotonsillar hypertrophy, and sleep-disordered breathing (SDB), with nocturnal enuresis. The underlying mechanisms may involve changes in sleep architecture, higher arousal thresholds, and hormonal imbalances, such as impaired antidiuretic hormone secretion. Our objective is to examine the link between upper airway obstruction and primary enuresis in children and to identify otolaryngologic predictors of enuresis severity. Methods: A retrospective clinical study involved 50 children aged 5-12 years diagnosed with primary enuresis. All patients received ENT examinations, including assessment of tonsillar hypertrophy (Brodsky scale), adenoid size (endoscopic grading), and nasal obstruction. Sleep-related symptoms such as snoring and mouth breathing were documented. Statistical analysis included chi-square tests and logistic regression. Results: UAO was identified in 68% of patients. Significant associations were found between enuresis and adenotonsillar hypertrophy (p<0.001), habitual snoring (p=0.002), and mouth breathing (p=0.01). Logistic regression showed that adenotonsillar hypertrophy was the strongest predictor (OR 4.5, 95% CI 2.1-9.8). Conclusion: Upper airway obstruction is significantly associated with primary enuresis in children. ENT evaluation should be considered in all enuretic patients.
