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Daytime bladder dysfunction in therapy-resistant nocturnal enuresis. A pilot study in urotherapy
S Kruse1, A L Hellström, K Hjälmås
1Department of Pediatric Surgery, University Children's Hospital, Gothenburg, Sweden.
Insights
Increasing daytime urination frequency can effectively treat childhood bedwetting (nocturnal enuresis) in children who have not responded to other therapies. This bladder training approach led to a reduction in wet nights for all participants.
Area of Science:
- Pediatric Urology
- Childhood Incontinence Research
Background:
- Nocturnal enuresis, or bedwetting, is common in children and can stem from various factors, including bladder dysfunction.
- The
- hold pattern,
- or infrequent voiding, is one such factor that may contribute to persistent bedwetting.
Purpose of the Study:
- To identify the
- hold pattern
- in children with severe bedwetting.
- To evaluate the efficacy of increasing daytime micturition frequency (bladder training) in treating nocturnal enuresis, particularly in children with a history of failed treatments.
Main Methods:
- A pilot study involving 22 children diagnosed with severe bedwetting.
- Treatment group 1 (12 children): Focused solely on increasing daytime micturition frequency.
- Treatment group 2 (10 children): Received increased daytime micturitions combined with either enuresis alarm therapy or desmopressin medication.
Main Results:
- All children experienced a decrease in the number of wet nights after one month of treatment.
- The positive effects of the treatment were sustained in the majority of children throughout the follow-up period.
- The study observed consistent improvement across both treatment groups.
Conclusions:
- Bladder training, specifically by increasing daytime voiding frequency, shows promise as a valuable non-pharmacological intervention for childhood nocturnal enuresis.
- This approach may be particularly beneficial for children who have not responded to previous treatment attempts.
Objective:
Bedwetting is the most common form of incontinence in children. Research in recent years suggests that there can be many different factors responsible for the problem of bed wetting, one of which is bladder dysfunction. The aim of this pilot study was to identify infrequent voiding ("hold pattern") and to investigate whether increasing the number of micturitions during the day can improve the nocturnal enuresis in children with several failed treatment attempts.
Material And Methods:
Twenty-two children with severe bedwetting were treated. Twelve of them had had no other treatment than increasing the number of regular micturitions during the day, while 10 patients had had enuresis alarm or desmopressin added.
Results:
The number of wet nights after 1 month of treatment decreased in all children and the improvement continued in most of the children during the follow-up period.
Conclusions:
This study suggests that bladder training by increasing the number of micturitions during the day can be valuable in the treatment of nocturnal enuresis.