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Published on: August 9, 2012
[Evaluation and treatment of the enuretic child: eight years' experience]
G Bartolozzi1, A Boldrini, A Salmeri
1Clinica Pediatrica I, Università di Firenze, Ospedale Meyer, Italia.
Insights
Bedwetting (enuresis) in children over seven can be effectively treated with conditioning alarm systems. This method, combined with counseling, achieved an 84% cure rate in a study, suggesting a biological basis for primary enuresis.
Area of Science:
- Pediatric functional disorders
- Urology
- Child psychology
Context:
- Enuresis, or involuntary urination, is a common childhood issue impacting social and psychological well-being.
- While often outgrown, persistent enuresis in children over seven warrants effective treatment.
- An established enuresis service has treated 541 children since 1983.
Purpose:
- To evaluate the effectiveness of a conditioning alarm system for treating nocturnal enuresis in children over seven.
- To compare outcomes of motivational counseling alone versus combined therapy.
- To explore potential etiological factors based on treatment response.
Summary:
- Initial treatment with motivational counseling cured 23% of 326 children.
- The remaining 250 children received conditioning alarm systems with counseling and psychological support.
- This combined approach resulted in an 84% permanent cure rate after six months, with 16% treatment failure and 35 relaxations.
Impact:
- The conditioning alarm system demonstrates high efficacy for nocturnal enuresis, particularly in children over seven.
- Positive treatment outcomes support the hypothesis that primary enuresis has a predominantly biological etiology.
- This study highlights the bell alarm as a successful intervention for persistent bedwetting.
Abstract:
Enuresis is a common functional problem among children which is defined as a complete involuntary voiding of urine at an age which control should be present. Bed wetting generally resolves with increasing age, but the restriction in social life and the psychological secondary problems, so frequent in older patients, justify an appropriate treatment of the problem in the child over seven. At children's Hospital of Florence University an enuresis service exists since 1983, and during these years 541 children applied to the structure. 326 children completed the treatment, among these there were 202 boy and 124 girls with age between 6 and 19. All the patients have been initially helped only with conversation (motivational counseling) and 76 among them (23% of the whole) obtained permanent cure. The remaining 250 children were treated with the conditioning alarm system, always associated to periodic conversation, urine stop exercises and other psychological support (token economy, etc). There were 161 boys and 89 girls: 220 children had nocturnal primary enuresis and 30 secondary. The family history was positive in 77%. The results obtained of this kind of treatment after a follow-up of 6 months, were permanent recovery in 211 children (84%) and failure in 39 patients (16% of the cases). There have been 35 relaxes. Regarding the sex, no significant difference was noted. These positive results with the conditioning devices favor the view that the etiology of primary enuresis is mainly biologic. The bell alarm represents the most effective treatment for nocturnal enuresis included more than seven.(ABSTRACT TRUNCATED AT 250 WORDS)
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