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Therapy concept in enuretic children
A Etele-Hainz1, E Artens, M Marberger
1Department of Urology, University of Vienna Medical School, Vienna, Austria. maria-angelika.etele@univie.ac.at
Insights
This study found that childhood enuresis, or bedwetting, is often linked to delayed maturation or disrupted sleep rhythms. Treatments include cognitive feedback for voiding issues and desmopressin for nighttime urine overproduction.
Area of Science:
- Pediatric Urology
- Developmental Pediatrics
Background:
- Childhood enuresis affects a significant number of children.
- Enuresis can stem from various underlying issues, including developmental delays and hormonal imbalances.
Purpose of the Study:
- To analyze the therapeutic approaches for childhood enuresis based on a detailed diagnostic scheme.
- To identify common causes and effective treatments for enuretic children.
Main Methods:
- A complex diagnostic scheme was employed to individually assess over 700 children aged 5-15 with enuresis.
- Treatment strategies were tailored based on the specific diagnosis for each child.
Main Results:
- Enuresis was frequently associated with delayed fine motor control maturation or disrupted circadian rhythms.
- While many cases lacked major physical pathology, neurourological issues were considered.
- Cognitive flow-triggered feedback and desmopressin (DDAVP) were utilized for specific enuresis subtypes.
Conclusions:
- Childhood enuresis often presents as a symptom of developmental delays rather than a primary disease.
- A personalized diagnostic and therapeutic approach is crucial for managing enuresis effectively.
- Specific treatments like cognitive feedback and desmopressin address distinct etiological factors in enuretic children.
Abstract:
More than 700 children aged between 5 and 15 years were treated at the University of Vienna Department of Urology during the last 10 years. The therapeutic approach was based on a complex diagnostic scheme to define the individual problem of each enuretic child. Generally speaking the enuresis problem turned out to be a symptom of delayed maturation of fine motor control [1] or sleep and hormone secretion rhythm during day and night hours. In a high percentage of enuretic children, no major physical problem or disease could be found, but the possibility of a physical problem, especially a neurourological problem, should not be ignored. Nonneurogenic discoordinated voiding in children can be treated by cognitive flow-triggered feedback training [2, 3] while overproduction of urine during sleep is reduced by antidiuretic hormone therapy with desmopressin (DDAVP; 1-deamino-8-D-arginine-vasopressin), a synthetic analogue of antidiuretic hormone.