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Childhood enuresis. A comprehensive treatment program
M B Scharf1, M F Pravda, S W Jennings
1Department of Psychiatry, University of Cincinnati School of Medicine, Ohio.
Insights
Bedwetting, or enuresis, is common in children. Early intervention is key to prevent psychological distress and improve outcomes, especially as children age.
Area of Science:
- Pediatrics
- Child Psychology
- Urology
Background:
- Enuresis affects millions of children, often leading to guilt and shame.
- Spontaneous resolution occurs at 15% per year, increasing treatment importance with age.
- Distinguishing primary from secondary enuresis is crucial for effective management.
Purpose of the Study:
- To review the management of enuresis in children.
- To highlight the importance of psychological well-being in enuresis treatment decisions.
- To present a multidimensional treatment approach.
Main Methods:
- Literature review of enuresis etiology and contributing factors.
- Discussion of pharmacologic, behavioral, and psychotherapeutic interventions.
- Presentation of a successful multidimensional treatment program.
Main Results:
- A careful history aids in identifying etiology and exacerbating factors.
- Multidimensional treatment approaches are often most effective.
- Successful treatment can be gratifying for the child, parents, and clinician.
Conclusions:
- Addressing psychological sequelae is vital in enuresis management.
- Timely and appropriate treatment can significantly benefit children with enuresis.
- A comprehensive, multidimensional approach yields positive outcomes.
Abstract:
Enuresis is a common, often misunderstood, condition that affects millions of children in the United States. For most children with primary enuresis, preventing secondary psychological sequelae associated with guilt and shame is an important consideration in the decision whether or not to treat. Because the spontaneous resolution rate is 15 per cent per year, the older the child, the more important treatment becomes. It is important to distinguish primary from secondary enuresis, as most psychogenically induced enuresis is of secondary nature. A careful history can usually elicit the etiology, as well as the exacerbatory factors in both types of conditions, providing direction for treatment. Treatments include pharmacologic, behavioral, and psychotherapeutic. In some cases, surgical intervention of either a urologic or otolaryngologic nature is indicated. A multidimensional approach is often best, and we have described our program with its success rate. Treating the enuretic child can be frustrating, but is usually quite gratifying for the child, parents, and the clinician.