Nocturnal enuresis in children
1Family Physician Associates, PA, of Tallahassee Pediatrics, Florida, USA.
Insights
Millions of children suffer from nocturnal enuresis, or bedwetting, which is often misunderstood and poorly managed. Behavioral management is the primary treatment, with medical options considered only after behavioral approaches fail.
Area of Science:
- Pediatrics
- Urology
- Child Psychology
Background:
- Nocturnal enuresis affects millions of children, yet remains poorly understood and managed.
- It is a symptom, complicating the identification of specific causes and effective treatments.
- While organic causes are rare (less than 5%), physical evaluation is crucial to rule them out.
Purpose of the Study:
- To review the understanding and management of nocturnal enuresis in children.
- To highlight associated factors and recommended therapeutic strategies.
Main Methods:
- Review of existing literature on nocturnal enuresis.
- Analysis of associated factors such as developmental delay, heredity, and hormonal factors.
- Evaluation of treatment modalities, emphasizing behavioral management.
Main Results:
- Associated factors include developmental delay, negative environmental factors, heredity, small bladder capacity, and reduced antidiuretic hormone secretion.
- Behavioral management is the cornerstone of therapy for childhood nocturnal enuresis.
- Medical management is reserved for cases where behavioral interventions have been unsuccessful.
Conclusions:
- Nocturnal enuresis requires a comprehensive approach, starting with behavioral strategies.
- Effective management may involve multiple therapeutic attempts to achieve dryness.
- Further research is needed to improve understanding and treatment efficacy.
Abstract:
Millions of children nationwide are affected by nocturnal enuresis. Despite the numbers of children affected, enuresis continues to be poorly understood is and often poorly managed. Because enuresis is a symptom and not a disease, it is difficult to discern a cause or an effective treatment. Although less than 5% of children with nocturnal enuresis have an organic basis for their wetting, the physical examination and history should carefully rule out any physical causes. Factors that have been observed to be associated with the occurrence of nocturnal enuresis include developmental delay, introduction of negative factors, heredity, small bladder capacity, and reduced nocturnal secretion of antidiuretic hormone. The cornerstone of therapy for all children with nocturnal enuresis should be behavioral management. Medical management should be initiated only after behavioral management has failed. No one therapy guarantees success, and multiple therapies may be attempted before dryness is obtained.
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