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Management of bedwetting
1Royal Children's Hospital, Melbourne.
Insights
Nocturnal enuresis (bedwetting) is a common condition impacting self-esteem. Effective treatments like alarm systems and desmopressin achieve over 90% success rates for persistent cases.
Area of Science:
- Pediatrics
- Urology
- Genetics
Background:
- Nocturnal enuresis (bedwetting) is a common, inherited condition affecting children and adults.
- It can cause significant emotional distress and negatively impact self-esteem, particularly in older children and adolescents.
- It is not a sign of laziness but a medical condition requiring understanding and treatment.
Purpose of the Study:
- To enhance general practitioners' understanding of nocturnal enuresis.
- To highlight the importance of accurate diagnosis and effective treatment strategies for bedwetting.
- To provide evidence-based guidance for managing this common condition.
Main Methods:
- Review of spontaneous remission rates in children over 10 years old.
- Evaluation of the effectiveness of common home-based interventions (e.g., waking to void, reward charts, fluid restriction).
- Assessment of treatment outcomes for alarm systems and desmopressin therapy.
Main Results:
- Spontaneous remission rates for nocturnal enuresis over age 10 are low, approximately 5% annually.
- Commonly attempted home treatments show limited effectiveness.
- Treatment with alarm systems is effective, with desmopressin showing high success rates in non-responders.
Conclusions:
- Nocturnal enuresis requires medical attention, as home remedies are often ineffective.
- Alarm systems and desmopressin are highly successful treatments for persistent bedwetting, with over 90% efficacy.
- Early diagnosis and appropriate intervention by general practitioners are crucial for managing nocturnal enuresis effectively.
Background:
Nocturnal enuresis (bedwetting) is a common inherited medical condition affecting both children and adults. It is not due to laziness. It can be distressing, embarrassing, humiliating and has a negative impact on self esteem and mood especially in children and young people over the age of 10 years.
Objective:
To assist busy general practitioners develop a better understanding of bedwetting and the importance of its diagnosis and treatment.
Discussion:
Spontaneous remission rates over the age of 10 years are low at 5% per year and approaches often tried at home such as waking to void, reward charts or fluid restriction are not effective. However, treatment with alarm systems or desmopressin for those who fail to respond to alarms is successful in over 90% of cases.