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Published on: January 30, 2018
Management of nocturnal enuresis in Greek children
A Triantafyllidis1, S Charalambous, A G Papatsoris
1Department of Urology, School of Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece. artriant@otenet.gr
Insights
This study found that desmopressin and anticholinergics are effective and safe treatments for childhood nocturnal enuresis. Behavioral therapy with a urinary alarm also showed positive results in managing bedwetting in children.
Area of Science:
- Pediatric Urology
- Clinical Pharmacology
Background:
- Nocturnal enuresis is a common condition in children, affecting their quality of life.
- Effective management strategies are crucial for successful treatment outcomes.
Purpose of the Study:
- To describe the management of primary nocturnal enuresis in Greek children.
- To evaluate the efficacy and safety of behavioral conditioning, desmopressin, and anticholinergics.
Main Methods:
- A prospective study included 142 children (7-18 years) with primary nocturnal enuresis.
- Initial treatment involved behavioral conditioning with a urinary alarm.
- Desmopressin and/or anticholinergics were administered if conditioning failed or based on urodynamic findings.
Main Results:
- The overall response rate was 51.41%.
- Desmopressin (with or without anticholinergics) was effective in 47 children.
- Behavioral therapy and anticholinergics also showed successful responses in subgroups.
Conclusions:
- Desmopressin and anticholinergics are effective and safe in managing childhood nocturnal enuresis.
- Treatment choice may depend on individual patient characteristics and urodynamic findings.
- Further research can explore long-term outcomes and optimal combination therapies.
Abstract:
Our experiences of managing nocturnal enuresis in Greek children at our Outpatient Clinics of Pediatric Urology are described. Between March 2001 and October 2003, 142 children with primary nocturnal enuresis (93 boys and 49 girls), aged 7-18 years old (mean: 9.0+/-0.5) were included in this prospective study. Initially, behavioral conditioning therapy, using a body-worn urinary alarm, was instructed in all cases. If no improvement was recorded, 40 microg of intranasal desmopressin was administered, initially for three months. If urodynamic studies demonstrated pure detrusor instability, anticholinergics (5 mg oxybutinine or 2 mg tolterodine) were given instead. Combination medication (desmopressin and anticholinergics) was administered for coexisting diurnal enuresis, which was present in 8 children. Among the 142 children the overall response rate was 51.41%. Successful response was recorded in 16 children practicing conditioning behavioral therapy, in 47 receiving desmopressin (with or without anticholinergics), and in 10 children receiving only anticholinergics. During the follow-up period (mean: 6.2 months), no serious side effect was recorded. The use of desmopressin, and anticholinergics in specific subgroups, was found to be effective and safe for the management of nocturnal enuresis in children.
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