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Enuresis: principles of management and result of treatment
Insights
A detailed urologic history guides treatment for primary enuresis. Anticholinergic medication is effective for diurnal/nocturnal enuresis or enuresis with urgency, while imipramine benefits nocturnal enuresis cases.
Area of Science:
- Pediatric Urology
- Nephrology
- Childhood Behavioral Health
Background:
- Primary enuresis affects many children, necessitating effective diagnostic and treatment strategies.
- Current guidelines suggest specific investigations for complex enuresis cases.
Purpose of the Study:
- To evaluate the diagnostic utility of specific tests in primary enuresis.
- To determine the most effective treatment protocols based on enuresis type and patient history.
Main Methods:
- Retrospective analysis of 115 primary enuresis cases.
- Correlation of urologic history with diagnostic testing and treatment outcomes.
- Categorization of enuresis into diurnal, nocturnal, and mixed types.
Main Results:
- Urologic history was the primary determinant for further investigations like excretory urography, urodynamic testing, and endoscopy.
- Anticholinergic medication showed significant improvement in up to 90% of patients with diurnal/nocturnal enuresis or enuresis with urgency/frequency.
- Imipramine achieved a 70% improvement rate in children with isolated nocturnal enuresis.
Conclusions:
- A detailed urologic history is crucial for managing primary enuresis, guiding the need for specialized investigations.
- Tailored pharmacotherapy, including anticholinergics and imipramine, demonstrates high efficacy rates for different enuresis subtypes.
Abstract:
We studied 115 consecutive cases of primary enuresis. Excretory urography, urodynamic testing and endoscopy are needed only in children with enuresis and concomitant urinary infection. A detailed urologic history was the most important factor in deciding upon a treatment program. Children with diurnal and nocturnal enuresis or nocturnal enuresis and daytime urgency and frequency of urination are started on anticholinergic medication. Girls with enuresis and urinary infection also are started on anticholinergic medication. Significant improvement occurs in up to 90% of the patients. Children with only nocturnal enuresis and no other symptoms are started on imipramine with a 70% improvement rate.