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Primary nocturnal enuresis: current
1Section of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756-0001, USA. Marc.Cendron@Hitchcock.org
Insights
Primary nocturnal enuresis, or bedwetting, affects children and parents, often due to developmental delays or genetics. Treatments range from behavioral therapies to medications like desmopressin.
Area of Science:
- Pediatric Urology
- Child Psychology
- Endocrinology
Background:
- Primary nocturnal enuresis (PNE) significantly impacts children's psychosocial well-being and family dynamics.
- Common etiological factors include maturational delay, genetic predisposition, arousal difficulties, and reduced nocturnal antidiuretic hormone (ADH) secretion.
- Anatomical abnormalities and psychological issues are typically not primary causes of PNE.
Purpose of the Study:
- To review the causes, evaluation methods, and treatment options for primary nocturnal enuresis in children.
- To provide an overview of current therapeutic strategies for managing bedwetting.
Main Methods:
- Diagnostic evaluation primarily involves a comprehensive medical history, targeted physical examination, and basic urinalysis (specific gravity and dipstick tests).
- Treatment approaches encompass non-pharmacologic interventions and pharmacologic therapies.
Main Results:
- Non-pharmacologic treatments include motivational therapy, behavioral conditioning, and bladder training.
- Pharmacologic options consist of imipramine, anticholinergic medications, and desmopressin, all demonstrating variable success rates.
- The diagnostic process is generally straightforward, avoiding extensive investigations for most cases.
Conclusions:
- Primary nocturnal enuresis is a multifactorial condition manageable through a combination of behavioral and medical interventions.
- Effective management strategies can alleviate the psychosocial burden associated with PNE for affected children and their families.
- Further research may refine treatment protocols for improved outcomes.
Abstract:
Primary nocturnal enuresis sometimes presents significant psychosocial problems for children and their parents. Causative factors may include maturational delay, genetic influence, difficulties in waking and decreased nighttime secretion of antidiuretic hormone. Anatomic abnormalities are usually not found, and psychologic causes are unlikely. Evaluation of enuresis usually requires no more than a complete history, a focused physical examination, and urine specific gravity and dipstick tests. Nonpharmacologic treatments include motivational therapy, behavioral conditioning and bladder-training exercises. Pharmacologic therapy includes imipramine, anticholinergic medication and desmopressin. These drugs have been used with varying degrees of success.