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Related Experiment Videos

Nocturnal enuresis

S D Mark1, J D Frank

  • 1Department of Urology, Christchurch Hospital, New Zealand.

British Journal of Urology
|April 1, 1995
PubMed
Summary
This summary is machine-generated.

Nocturnal enuresis, or bedwetting, is often caused by insufficient antidiuretic hormone (ADH) production at night. Treatment depends on the type of enuresis, with behavioral methods offering the best long-term results.

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Area of Science:

  • Pediatrics
  • Urology
  • Sleep Medicine

Background:

  • Nocturnal enuresis (bedwetting) is a common condition with unclear causes.
  • Emerging evidence suggests a link to insufficient nocturnal antidiuretic hormone (ADH) levels, leading to excessive nighttime urine production (nocturnal polyuria).
  • Sleep disturbances, specifically arousal disorders, may also contribute to enuresis.

Purpose of the Study:

  • To review the current understanding of nocturnal enuresis etiology and management.
  • To differentiate between uncomplicated and complicated enuresis and guide appropriate investigation and treatment.
  • To provide an overview of available treatment options, including behavioral and pharmacological approaches.

Main Methods:

  • Literature review of recent evidence on nocturnal enuresis.

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  • Categorization of enuresis into uncomplicated and complicated forms.
  • Evaluation of treatment modalities: reassurance, education, behavioral modification, and pharmacotherapy (DDAVP, imipramine, anticholinergics).

    • Main Results:

    • Uncomplicated enuresis requires reassurance and education; resource centers like ERIC offer support.
    • Behavioral modification has the highest long-term cure rate but demands significant commitment and is best for children over 7-8 years.
    • Pharmacotherapy with DDAVP shows high initial response rates (up to 70%) but has a high relapse rate. Imipramine is cheaper but carries overdose risks. Anticholinergics are for specific cases.

    Conclusions:

    • Nocturnal enuresis management should be individualized based on patient age, motivation, and parental preferences.
    • Reassurance regarding the high spontaneous cure rate is crucial for patients and parents.
    • A combination of evaluation, education, and tailored treatment strategies, including behavioral or pharmacological options, is recommended.