Childhood enuresis. Epidemiology, pathophysiology and management

The goal of this article is to review childhood enuresis, which is a common behavioral condition reported in millions of children worldwide. An online computer search was made, and the literature up to 1997 was screened in order to include relevant data for this review. The prevalence of childhood enuresis varies across reviewed studies. This was attributed to a variety of sociodemographic and cultural dynamics of societies. Similarly, the pathophysiology of this ubiquitous symptom is determined by multiple risk factors including biological, psychological, social, and cultural, but the developmental/maturational delay influenced by genetics remains the most plausible explanation. Although a variety of pharmacological and non-pharmacological treatment modalities are traced in the literature, there is yet no agreement on a single strategy. A general agreement about behavioral therapy as the first choice of treatment of this minor malady began to emerge. Additionally, tricyclic antidepressants are the most frequently prescribed drugs for the treatment of childhood enuresis. Enuresis is a pediatric public health problem and concerted efforts at all levels, ie, professional, promotional, educational and public should be made to address its multiple domains such as preventive, etiological and curative.