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[Etiology primary, monosymptomatic nocturnal enuresis in children. Own research]
Bożena Eberdt-Gołąbek1, Krystyna Zmysłowska, Małgorzata Słowik
1Zdrojowa 46, 02-927 Warszawa, ebert-golabek@gmail.com.
Insights
Primary monosymptomatic nocturnal enuresis in children is often caused by bladder overactivity or nocturnal polyuria. This common condition has organic, not mental, origins, requiring individualized diagnosis and treatment.
Area of Science:
- Pediatric Nephrology
- Urology
- Child Development
Context:
- Primary monosymptomatic nocturnal enuresis (PMNE) is the most common form of enuresis in children, affecting 85% of cases.
- Understanding the underlying causes of PMNE is crucial for selecting effective therapeutic strategies.
- This condition is often underestimated and frequently misattributed to psychological factors.
Purpose:
- To investigate and establish the specific causes of primary monosymptomatic nocturnal enuresis in a pediatric cohort.
- To differentiate between organic and psychological etiologies of PMNE.
- To inform diagnostic and therapeutic approaches for children with PMNE.
Summary:
- The study analyzed 47 children (36 boys, 21 girls) aged 5.5 to 15.5 years with PMNE.
- Destructor over-activity was the most frequent cause (55.3%), followed by nocturnal polyuria (21.3%).
- Combined destructor over-activity and polyuria occurred in 12.8%, while incorrect fluid/voiding habits accounted for 10.6%.
Impact:
- Findings confirm that PMNE has heterogeneous, organic origins, challenging the notion of psychosomatic causes.
- Highlights the need for a personalized diagnostic and therapeutic approach for each child.
- Aims to reduce the stigma associated with PMNE by emphasizing its organic basis.
Introduction:
Primary monosymptomatic nocturnal enuresis is the most frequent (85%) type of enuresis in children. Establishing its causes enables the choice of effective therapy.
Aim:
To establish the causes of primary, monosymptomatic nocturnal enuresis in children on the basis of own investigations.
Material And Methods:
The study concerned 47 children (36 boys and 21 girls) with primary, monosymptomatic nocturnal enuresis aged from 5 years 5 months to 15.5 years. The patients were under the care of Nephrological Outpatient Clinic at the Institute of Mother and Child in the years 2009-2013. The detailed medical history, physical examination as well as laboratory investigations of blood and urine and radiological investigations of the urinary tract, were carried out.
Results:
The most frequent causes of nocturnal enuresis in the studied groups was destructor over-activity (55,3%). Other causes were: nocturnal polyuria (21,3%) and destructor overactivity together with polyuria (12,8%). In a lower percentile (10,6%) the causes of nocturnal enuresis were incorrect habits concerning drinking, time and amount of fluids taken before sleep and the lack of habits to pass urine before sleep.
Conclusions:
1. Primary monosymptomatic nocturnal enuresis is a significant underestimated problem. 2. Etiology of nocturnal enuresis in the developmental period has heterogenous origin and requires individual diagnostic and therapeutic approach. 3. Obtained results of investigations conclude that primary monosymtomatic nocturnal enuresis is conditioned by concrete organic and not mental causes as is quite often suggested, and in this way stigmatizing the population in which this disorder is found.
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