Tags

Type your tag names separated by a space and hit enter

Primary monosymptomatic nocturnal enuresis in children and adolescents.

Abstract

Nocturnal enuresis (NE) is one of the most frequent paediatric pathologies. The prevalence of primary nocturnal enuresis (PNE) is around 9% in children between 5 and 10 years of age and about 40% of them have one or more episodes per week. Still for too long, PNE has not been recognised as a pathological condition, particularly by the medical community; as a consequence, there was no specific education at medical school, and a poor involvement by the practitioners. Enuretic children have a sense of social difference and isolation; some of them do express a low self-esteem. Also, self-esteem is improved by the management NE even if this management fails to cure the condition. Primary monosymptomatic nocturnal enuresis (PMNE) is an heterogeneous condition for which various causative factors have been identified such as: nocturnal polyuria, sleep disturbances, reduced bladder capacity or bladder dysfunction, upper airway obstruction. The positive diagnosis of PMNE is based on a complete questionnaire and a careful physical examination. A drinking and voiding chart is an essential non-invasive tool: first, to collect information about the initial drinking and voiding habits of the child, then to reassess the accuracy of the diagnosis. Only motivated patients should receive a specific treatment for their NE and the treatment should be proposed based on the type of PMNE. PMNE associated with nocturnal polyuria should be treated with desmopressin, which reduces nighttime urine production. For PMNE with a reduced bladder capacity alarms should be the first-line treatment. Oxybutinin, a drug with anticholinergic properties, is not theoretically indicated for the treatment of PMNE except for a very small subgroup of patients who have an overactive bladder only during sleep. In cases refractory to monotherapy, NE is probably the result of an association of different physiopathological factors (e.g. both a nocturnal polyuria together with a small bladder capacity) some of them are still unknown. In these patients, a combination of treatments may be more effective than monotherapy. Various combination therapies can be proposed to improve the cure rates.

Authors+Show Affiliations

Paediatric Urology Unit, Service de Chirurgie Viscerale Pediatrique, Hôpital Necker-Enfants Malades, Paris, France. henrilottmann@wanadoo.frNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17727574

Citation

Lottmann, H B., and I Alova. "Primary Monosymptomatic Nocturnal Enuresis in Children and Adolescents." International Journal of Clinical Practice. Supplement, 2007, pp. 8-16.
Lottmann HB, Alova I. Primary monosymptomatic nocturnal enuresis in children and adolescents. Int J Clin Pract Suppl. 2007.
Lottmann, H. B., & Alova, I. (2007). Primary monosymptomatic nocturnal enuresis in children and adolescents. International Journal of Clinical Practice. Supplement, (155), 8-16.
Lottmann HB, Alova I. Primary Monosymptomatic Nocturnal Enuresis in Children and Adolescents. Int J Clin Pract Suppl. 2007;(155)8-16. PubMed PMID: 17727574.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary monosymptomatic nocturnal enuresis in children and adolescents. AU - Lottmann,H B, AU - Alova,I, PY - 2007/10/18/pubmed PY - 2008/3/6/medline PY - 2007/10/18/entrez SP - 8 EP - 16 JF - International journal of clinical practice. Supplement JO - Int J Clin Pract Suppl IS - 155 N2 - Nocturnal enuresis (NE) is one of the most frequent paediatric pathologies. The prevalence of primary nocturnal enuresis (PNE) is around 9% in children between 5 and 10 years of age and about 40% of them have one or more episodes per week. Still for too long, PNE has not been recognised as a pathological condition, particularly by the medical community; as a consequence, there was no specific education at medical school, and a poor involvement by the practitioners. Enuretic children have a sense of social difference and isolation; some of them do express a low self-esteem. Also, self-esteem is improved by the management NE even if this management fails to cure the condition. Primary monosymptomatic nocturnal enuresis (PMNE) is an heterogeneous condition for which various causative factors have been identified such as: nocturnal polyuria, sleep disturbances, reduced bladder capacity or bladder dysfunction, upper airway obstruction. The positive diagnosis of PMNE is based on a complete questionnaire and a careful physical examination. A drinking and voiding chart is an essential non-invasive tool: first, to collect information about the initial drinking and voiding habits of the child, then to reassess the accuracy of the diagnosis. Only motivated patients should receive a specific treatment for their NE and the treatment should be proposed based on the type of PMNE. PMNE associated with nocturnal polyuria should be treated with desmopressin, which reduces nighttime urine production. For PMNE with a reduced bladder capacity alarms should be the first-line treatment. Oxybutinin, a drug with anticholinergic properties, is not theoretically indicated for the treatment of PMNE except for a very small subgroup of patients who have an overactive bladder only during sleep. In cases refractory to monotherapy, NE is probably the result of an association of different physiopathological factors (e.g. both a nocturnal polyuria together with a small bladder capacity) some of them are still unknown. In these patients, a combination of treatments may be more effective than monotherapy. Various combination therapies can be proposed to improve the cure rates. SN - 1368-504X UR - https://www.unboundmedicine.com/medline/citation/17727574/Primary_monosymptomatic_nocturnal_enuresis_in_children_and_adolescents_ DB - PRIME DP - Unbound Medicine ER -