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Therapeutic options in childhood nocturnal enuresis.
Minerva Urol Nefrol. 2007 Jun; 59(2):199-205.MU

Abstract

Monosymptomatic nocturnal enuresis, a heterogeneous condition, is frequently treated in children aged >5 years. Of the various treatment options, enuresis alarm has been widely advocated as being effective for treating nocturnal enuresis, while extracorporeal pelvic floor magnetic stimulation for overactive bladder, urge incontinence and urgency-frequency syndrome has not yet been confirmed by controlled studies as primary treatment for monosymptomatic nocturnal enuresis. Desmopressin, an antidiuretic hormone (ADH) analog, or arginine vasopressin (AVP), can resolve primary nocturnal enuresis by decreasing night-time urine production. Enuretic children requiring either desmopressin or desmopressin plus oxybutynin to achieve dryness have polyuria. Tricyclic antidepressants (i.e. imipramine) are used successfully in enuretic children. Although tricyclics and desmopressin are effective in reducing the number of wet nights, most children relapse after discontinuation of active treatment. Combined therapy (enuresis alarm, bladder training, motivational therapy and pelvic floor muscle training) is more effective than each component alone or than pharmacotherapy. Furthermore, desmopressin combined with alarm therapy has a positive effect on enuresis. Pharmacotherapy can provide early relief of enuresis, while behavioral intervention may lead to greater long-term benefits. The positive effect of achieving dry nights with pharmacotherapy can encourage the child to sustain behavioral therapy.

Authors+Show Affiliations

Department of Pediatrics, University of Verona, Verona, Italy. marco.zaffanello@univr.itNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17571056

Citation

Zaffanello, M, et al. "Therapeutic Options in Childhood Nocturnal Enuresis." Minerva Urologica E Nefrologica = the Italian Journal of Urology and Nephrology, vol. 59, no. 2, 2007, pp. 199-205.
Zaffanello M, Giacomello L, Brugnara M, et al. Therapeutic options in childhood nocturnal enuresis. Minerva Urol Nefrol. 2007;59(2):199-205.
Zaffanello, M., Giacomello, L., Brugnara, M., & Fanos, V. (2007). Therapeutic options in childhood nocturnal enuresis. Minerva Urologica E Nefrologica = the Italian Journal of Urology and Nephrology, 59(2), 199-205.
Zaffanello M, et al. Therapeutic Options in Childhood Nocturnal Enuresis. Minerva Urol Nefrol. 2007;59(2):199-205. PubMed PMID: 17571056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapeutic options in childhood nocturnal enuresis. AU - Zaffanello,M, AU - Giacomello,L, AU - Brugnara,M, AU - Fanos,V, PY - 2007/6/16/pubmed PY - 2007/10/13/medline PY - 2007/6/16/entrez SP - 199 EP - 205 JF - Minerva urologica e nefrologica = The Italian journal of urology and nephrology JO - Minerva Urol Nefrol VL - 59 IS - 2 N2 - Monosymptomatic nocturnal enuresis, a heterogeneous condition, is frequently treated in children aged >5 years. Of the various treatment options, enuresis alarm has been widely advocated as being effective for treating nocturnal enuresis, while extracorporeal pelvic floor magnetic stimulation for overactive bladder, urge incontinence and urgency-frequency syndrome has not yet been confirmed by controlled studies as primary treatment for monosymptomatic nocturnal enuresis. Desmopressin, an antidiuretic hormone (ADH) analog, or arginine vasopressin (AVP), can resolve primary nocturnal enuresis by decreasing night-time urine production. Enuretic children requiring either desmopressin or desmopressin plus oxybutynin to achieve dryness have polyuria. Tricyclic antidepressants (i.e. imipramine) are used successfully in enuretic children. Although tricyclics and desmopressin are effective in reducing the number of wet nights, most children relapse after discontinuation of active treatment. Combined therapy (enuresis alarm, bladder training, motivational therapy and pelvic floor muscle training) is more effective than each component alone or than pharmacotherapy. Furthermore, desmopressin combined with alarm therapy has a positive effect on enuresis. Pharmacotherapy can provide early relief of enuresis, while behavioral intervention may lead to greater long-term benefits. The positive effect of achieving dry nights with pharmacotherapy can encourage the child to sustain behavioral therapy. SN - 0393-2249 UR - https://www.unboundmedicine.com/medline/citation/17571056/Therapeutic_options_in_childhood_nocturnal_enuresis_ DB - PRIME DP - Unbound Medicine ER -