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Refractory monosymptomatic nocturnal enuresis: a combined stepwise approach in childhood and follow-up into adolescence, with attention to the clinical value of normalizing bladder capacity.
BJU Int. 2005 Sep; 96(4):629-33.BI

Abstract

OBJECTIVE

To assess the importance of normalizing bladder capacity to the age-expected capacity in children with refractory monosymptomatic nocturnal enuresis (MNE), and to evaluate the long-term results when these children grow into adolescence.

PATIENTS AND METHODS

The study included 34 children with refractory MNE; all were treated > 5 years earlier for their MNE using a combined stepwise approach, consisting of retention control training, oxybutynin and an enuresis alarm. Data were obtained on their enuretic state, night-time voiding behaviour and bladder capacity, from a questionnaire and a voiding chart.

RESULTS

Before starting treatment, all patients had a bladder capacity that was too small for their age. After the combined stepwise approach, MNE improved in all patients and 24 (71%) were cured. Although the bladder capacity was increased to the age-expected capacity in 26 (76%), most woke at night to void. Currently, at a mean of 7.7 years after the primary treatment, 28 (82%) of the patients are completely dry at night, of whom 15 (54%) arouse to void for 35% of the nights. Six patients (18%) still have some enuretic episodes. Only those who were dry after primary treatment and remained dry had a normal age-expected increase in bladder capacity. For all others there was a decrease in age-related bladder capacity.

CONCLUSIONS

In patients with refractory MNE, a combined stepwise approach improves and may even eliminate enuresis, but normal night-time bladder behaviour in adolescence and adulthood is only achieved in some. Furthermore, about a fifth still have some enuretic episodes.

Authors+Show Affiliations

Department of Urology, University of Antwerpen, Edegem, Belgium.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

16104923

Citation

Vermandel, Alexandra, et al. "Refractory Monosymptomatic Nocturnal Enuresis: a Combined Stepwise Approach in Childhood and Follow-up Into Adolescence, With Attention to the Clinical Value of Normalizing Bladder Capacity." BJU International, vol. 96, no. 4, 2005, pp. 629-33.
Vermandel A, de Wachter S, Wyndaele JJ. Refractory monosymptomatic nocturnal enuresis: a combined stepwise approach in childhood and follow-up into adolescence, with attention to the clinical value of normalizing bladder capacity. BJU Int. 2005;96(4):629-33.
Vermandel, A., de Wachter, S., & Wyndaele, J. J. (2005). Refractory monosymptomatic nocturnal enuresis: a combined stepwise approach in childhood and follow-up into adolescence, with attention to the clinical value of normalizing bladder capacity. BJU International, 96(4), 629-33.
Vermandel A, de Wachter S, Wyndaele JJ. Refractory Monosymptomatic Nocturnal Enuresis: a Combined Stepwise Approach in Childhood and Follow-up Into Adolescence, With Attention to the Clinical Value of Normalizing Bladder Capacity. BJU Int. 2005;96(4):629-33. PubMed PMID: 16104923.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Refractory monosymptomatic nocturnal enuresis: a combined stepwise approach in childhood and follow-up into adolescence, with attention to the clinical value of normalizing bladder capacity. AU - Vermandel,Alexandra, AU - de Wachter,Stefan, AU - Wyndaele,Jean-Jacques, PY - 2005/8/18/pubmed PY - 2005/9/29/medline PY - 2005/8/18/entrez SP - 629 EP - 33 JF - BJU international JO - BJU Int VL - 96 IS - 4 N2 - OBJECTIVE: To assess the importance of normalizing bladder capacity to the age-expected capacity in children with refractory monosymptomatic nocturnal enuresis (MNE), and to evaluate the long-term results when these children grow into adolescence. PATIENTS AND METHODS: The study included 34 children with refractory MNE; all were treated > 5 years earlier for their MNE using a combined stepwise approach, consisting of retention control training, oxybutynin and an enuresis alarm. Data were obtained on their enuretic state, night-time voiding behaviour and bladder capacity, from a questionnaire and a voiding chart. RESULTS: Before starting treatment, all patients had a bladder capacity that was too small for their age. After the combined stepwise approach, MNE improved in all patients and 24 (71%) were cured. Although the bladder capacity was increased to the age-expected capacity in 26 (76%), most woke at night to void. Currently, at a mean of 7.7 years after the primary treatment, 28 (82%) of the patients are completely dry at night, of whom 15 (54%) arouse to void for 35% of the nights. Six patients (18%) still have some enuretic episodes. Only those who were dry after primary treatment and remained dry had a normal age-expected increase in bladder capacity. For all others there was a decrease in age-related bladder capacity. CONCLUSIONS: In patients with refractory MNE, a combined stepwise approach improves and may even eliminate enuresis, but normal night-time bladder behaviour in adolescence and adulthood is only achieved in some. Furthermore, about a fifth still have some enuretic episodes. SN - 1464-4096 UR - https://www.unboundmedicine.com/medline/citation/16104923/Refractory_monosymptomatic_nocturnal_enuresis:_a_combined_stepwise_approach_in_childhood_and_follow_up_into_adolescence_with_attention_to_the_clinical_value_of_normalizing_bladder_capacity_ L2 - https://doi.org/10.1111/j.1464-410X.2005.05697.x DB - PRIME DP - Unbound Medicine ER -