The treatment of primary nocturnal enuresis in Malaysia
1Department of Paediatrics, Faculty of Medicine, Hospital Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur.
Insights
This study shows that fluid management, reward systems, and oral desmopressin effectively treat primary nocturnal enuresis in Malaysian children. Treatments significantly reduced wetting frequency with no adverse events reported.
Area of Science:
- Pediatric Nephrology
- Urology
- Sleep Medicine
Background:
- Primary nocturnal enuresis (PNE) is a common condition affecting children.
- Effective treatment strategies are crucial for improving quality of life.
Purpose of the Study:
- To evaluate treatment outcomes for PNE in Malaysian children.
- To assess the efficacy of non-pharmacological methods and oral desmopressin.
Main Methods:
- Prospective data collection from 71 children (aged 6-18) at Hospital UKM Enuresis Clinic.
- Interventions included fluid management, reward systems, and oral desmopressin for children with >= 6 wet nights/14 nights.
- Treatment response defined as partial (>50% reduction) or full (complete dryness).
Main Results:
- 32.4% responded to non-pharmacological methods alone (4 full, 19 partial).
- 51.2% responded to oral desmopressin (varying dosages).
- 32% achieved complete dryness; mean wetting frequency significantly reduced in both groups (p < 0.01).
Conclusions:
- Non-pharmacological methods and oral desmopressin are effective and well-tolerated treatments for PNE in Malaysian children.
- Treatment leads to significant reductions in wetting frequency.
- Discontinuation of desmopressin resulted in increased wetting, but remained lower than baseline.
Abstract:
To determine treatment outcomes in Malaysian children with primary nocturnal enuresis using both non-pharmacological methods and oral desmopressin. Data was collected prospectively from children aged 6-18 years who were referred to the Hospital UKM Enuresis Clinic. Treatment was given to those with a baseline wetting frequency of at least six wet nights/14 nights. Three modalities were offered: fluid management, reward system and oral desmopressin. Response was recorded as partial (> or = 50% reduction in WN from baseline) or full (completely dry). Seventy-one healthy children completed 12 weeks of therapy. Twenty-three children (32.4%) responded to non-pharmacological methods alone (4 full and 19 partial). Another 37 children (51.2%) responded to oral desmopressin (32 to 0.2mg, 4 to 0.4mg and 1 to 0.6mg). Thirty-two percent became dry whilst on therapy. The mean wetting frequency during treatment was significantly reduced (p < 0.01) compared to the baseline mean for both the non-pharmacological group and the desmopressin group. Discontinuation of desmopressin after 12 weeks increased the wetting frequency but this was still significantly lower than at baseline (p < 0.01). No adverse ents were recorded. Treatment of primary nocturnal enuresis in Malaysian children is both effective and well tolerated using fluid management strategies, reward systems and oral desmopressin.
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