Enuresis In Children Research Articles

Treatment of Enuresis in Children with Xuantong Kaiqiao Method

Treatment of Enuresis in Children with Xuantong Kaiqiao Method

Upper airway obstruction and nocturnal enuresis in children: Why is it important?

Objectives: Nocturnal enuresis (NE) is a common urological complaint among children. The most common cause of obstructive airway disease in children is enlarged tonsils and adenoids. Although the relationship between the presence of NE and sleep disorders is unclear, some studies show that enuresis improves after airway obstruction is resolved. We aimed to investigate the relationship between upper airway obstruction and NE in children. Methods: Between September 2020 and June 2021, 66 pediatric patients diagnosed with persistent NE were included in the study. A total of 57 healthy patients were included in the control group. The presence of snoring and apnea, the presence of Attention-Deficit/Hyperactivity Disorder (ADHD)/social adjustment disorder, academic achievement, and family members’ history of NE were asked through questionnaires filled out by the families. An upper airway examination was done with a flexible nasopharyngoscope. Results: The mean ages of the study patients and healthy controls were 8.32±2.1 and 8.18±2.3 years. The female/male ratio was (25/41) and (33/24), respectively. Of the case group, 62.1% were male, and 78.8% were under nine years old. The frequency of snoring/apnea in children with enuresis was 27.3%, while it was 19.3% in the control group (p=0.299). It was found that more enuresis developed in children with high BMI (p=0.044). Family history was higher in the NE group than in the control group, but it was not statistically significant (p=0.173). Conclusion: Nocturnal enuresis is commonly associated with obstructive sleep apnea. Upper airway obstruction, obesity, and male gender are important risk factors for NE.

Overview on the management of nocturnal enuresis in children in general pediatrics

Bedwetting, or enuresis, represents a socially stigmatizing and distressing condition that significantly impacts the quality of life for both children and their parents. This article seeks to assess and consolidate the current understanding of traditional and innovative treatments, both pharmacological and non-pharmacological, for children with enuresis. The article discusses the various treatment modalities which have been developed and validated to alleviate symptoms of enuresis, enhance quality of life, and address the social and emotional challenges faced by affected children. Finally the article emphasizes the important primary role of general pediatricians that is to tailor therapy protocols to each individual child, considering their unique needs and circumstances, and working closely with their families to identify the most effective approach.

A systematic review and meta-analysis assessing the efficacy of Tuina for nocturnal enuresis in children.

Background: Desmopressin acetate (DDAVP) and behavioral interventions (BI) are cornerstone treatments for nocturnal enuresis (NE), a common pediatric urinary disorder. Despite the growing body of clinical studies on massage therapy for NE, comprehensive evaluations comparing the effectiveness of Tuina with DDAVP or BI are scarce. This study aims to explore the efficacy of Tuina in the management of NE. Methods: A systematic search of international databases was conducted using keywords pertinent to Tuina and NE. The inclusion criteria were limited to randomized controlled trials (RCTs) that evaluated NE treatments utilizing Tuina against DDAVP or BI. This meta-analysis included nine RCTs, comprising a total of 685 children, to assess both complete and partial response rates. Results: Tuina, used as a combination therapy, showed enhanced clinical efficacy and improved long-term outcomes relative to the control group. The therapeutic efficacy of Tuina was not directly associated with the number of acupoints used. Instead, employing between 11 and 20 acupoints appeared to have the most significant effect. Conclusion: The findings of this meta-analysis support the potential of Tuina as an adjunct therapy to enhance the sustained clinical efficacy of traditional treatments for NE. However, Tuina cannot completely replace DDAVP or BI in the management of NE. While this study illuminates some aspects of the effective acupoint combinations, further research is crucial to fully understand how Tuina acupoints contribute to the treatment of NE in children. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=442644, identifier CRD42023442644.

Effects of sex, toilet training, stress, and caffeine on nocturnal enuresis among school children in Gondar Town, the metropolitan city of Ethiopia: a community-based study in 2023.

Nocturnal enuresis is associated with severe social and psychological problems that affect one's self-esteem, later in life, harmed adolescent and adult life, emotional stress on the family, and poor school performance. Moreover, enuresis children may cause panic attacks, mood disorders, and depression. This study aims to assess the prevalence and associated factors of nocturnal enuresis among children aged 5-14 years in Gondar city, Northwest Ethiopia, 2023. A community-based, cross-sectional study was conducted from April 1, 2023, to May 30, 2023. A stratified multistage sampling technique was used to select study subject from kebeles in Gondar city. The data were collected by using a structured, interviewer-administer Questionnaire. The data were entered using EPI DATA version 4.6.02 software, and processed,and analyzed using the statistical package for the social sciences (SPSS) version 25. All variables with P ≤ 0.25 in the bivariate analysis were included in the final model of multivariate analysis. The multivariate binary logistic regression was used to assess the association between the independent and outcome variable. The direction and strength of statistical association were measured with an adjusted odds ratio along with 95% CI and a P-value <0.05 was considered statistically significant. The overall prevalence of nocturnal enuresis among children aged 5-14 years was 162 (22.2%). The findings showed that being boys [AOR = 0.54; 95% CI (0.31, 0.93)], child and no toilet training practices [AOR = 2.50; 95% CI (1.02, 6.15)], Having no caffeine [AOR = 0.16; 95% CI (0.09, 0.29)], and exposure to stressful events [AOR = 20; 95% CI (11.12, 33.34)] had a significant association with nocturnal enuresis, p-value <0.05. In this study, the prevalence of nocturnal enuresis children age 5-14 years was higher than that in previous studies. Sex of child, toilet training practices, caffeine c before bed, and presences of stressful event were a significant predictor of nocturnal enuresis.

Knowledge and Awareness of Adults towards Nocturnal Enuresis in Children among the Medina Population.

Background: Nocturnal Enuresis (NE) is a common problem among children that is stressful for both the child and adults. There is a lack of adults' knowledge and awareness of the NE condition. Objective: This study aimed to evaluate the adults' knowledge and awareness of NE in Medina City, Saudi Arabia. Method: A cross-sectional observational study was conducted among adults in Medina through September and October 2023, using a questionnaire composed of socio-demographic characteristics and adults' knowledge and awareness of NE. A statistical analysis was performed using SPSS software. Results: The study was conducted among 553 adults in Medina, with a mean (standard deviation [SD]) age of 37.69 (10.775). Most participants (94.8%) were Saudi nationals, of which 84.4% were females, 76.3% were married, and 97.1% were urban residents with university degrees (80.3%). The mean (SD) total score of knowledge and awareness was 4.69 (1.783) out of 9 and 6.49 (2.167) out of 12, respectively. Being female (p < 0.001), with a university degree (p = 0.002), and knowing about enuresis in children (p = 0.011) are significant factors affecting adults' knowledge with higher scores than others. Conclusions: An inadequate knowledge and awareness level of NE in children was revealed among adults living in Medina City, Saudi Arabia. These results emphasize the need for targeted educational campaigns to enhance adults' knowledge and awareness of enuresis.

BDNF, proBDNF and proBDNF/BDNF ratio with electroencephalographic abnormalities in children with attention deficit hyperactivity disorder: Possible relations to cognition and severity.

Attention deficit hyperactivity disorder (ADHD) with and without subclinical epileptogenic discharges (SED) have been suggested to negatively affect cognitive abilities of children with ADHD. The role of brain-derived neurotrophic factor (BDNF) and its precursor proBDNF in ADHD is in need of being investigated. The aims were to evaluate the levels of serum BDNF, proBDNF and the proBDNF/BDNF ratio in addition to the potential impacts of SED on the children's cognitive abilities and the severity of ADHD. The included participants with ADHD were 30 children with normal electroencephalogram (EEG) (G1) and 30 children with SED (G2), together with 30 healthy children (G3). The cognitive abilities and severity of the disorder were evaluated. The biochemical measures were determined by ELISA. The presence of coexisting SED and nocturnal enuresis has led to a deleterious effect on cognitive processes but not on the severity. The focal epileptogenic discharge was the most common among children in G2. The levels of BDNF in Groups 1 and 2 were less than those in G3. The higher proBDNF/BDNF ratio could be related to the low BDNF levels rather than high proBDNF levels. The findings of this study highlight the importance of investigating the presence of SED and nocturnal enuresis in children with ADHD. Targeting strengthening of cognitive abilities in children with coexisting ADHD and SED is advised. The role of proBDNF in the pathophysiology of ADHD needs further investigation.

Efficacy and safety of combination therapy (desmopressin with tolterodine) in nocturnal enuresis in children: An institutional experience

ABSTRACT Background: Nocturnal enuresis is one of the most common problems of childhood. Desmopressin is started as a first-line treatment along with essential behavioral therapy like fluid restriction before bed and sleep hygiene. Given the high relapse rates seen with using desmopressin alone, the need of the hour is to reinforce its effects using another agent so that the remission is long-lasting. Aim: The aim is to look for efficacy and safety of treatment using combination therapy of desmopressin with tolterodine in nocturnal enuresis and further to look for the relapse rate with a structured withdrawal regimen. Results: A total of 150 patients of nocturnal enuresis were included in the study. Ninety patients (75%) were males, and 30 patients (25%) were females. The median age of patients was 12 years. Evaluation of the consequences at 1 month, 3 months, and 6 months revealed complete remission in 87 patients (72.5%), 105 patients (87.5%), and 105 patients (87.5%), respectively. After 12 months with desmopressin + tolterodine, it was found that 99 patients (82.5%) had complete remission, six patients (5%) had a relapse, and 12.5% of individuals still suffered from enuresis. The relapse rate on follow-up of 6 months after complete cessation of the treatment of 120 patients was 5% in combination therapy. The complication rate with combination therapy is 4.17%. There is no significant effect of gender or age on improvement with combination therapy. Conclusion: Desmopressin given in combination with tolterodine is safe and effective as combination therapy for treating nocturnal enuresis, and in most cases, long-term remissions can be achieved.

Approach to nocturnal enuresis in children

Approach to nocturnal enuresis in children

Role of Homoeopathy in the Treatment of Nocturnal Enuresis in Children Under 16 Year of Age

Role of Homoeopathy in the Treatment of Nocturnal Enuresis in Children Under 16 Year of Age

Laser versus Needle Acupuncture in the Management of Nocturnal Enuresis in Children: A Randomized–Controlled Trial.

Laser versus Needle Acupuncture in the Management of Nocturnal Enuresis in Children: A Randomized–Controlled Trial.

To Study the Role of Homoeopathy in Nocturnal Enuresis in Children

To Study the Role of Homoeopathy in Nocturnal Enuresis in Children

Research Progress on the Pathogenesis of Primary Enuresis in Children

Nocturnal enuresis (NE) is a common disease in children, commonly known as bedwetting. The International Children's Continence Society (ICCS) defines intermittent urinary incontinence during nighttime sleep in children aged 5 and above as enuresis. Enuresis can be divided into two types: primary nocturnal enuresis (PNE) and secondary nocturnal enuresis (SNE). PNE refers to nocturnal urinary control ability that has never been achieved for more than 6 months in children aged 5 and above with enuresis; SNE refers to the recurrence of enuresis symptoms after a period of more than 6 months of continuous nocturnal urinary control ability. SNE is relatively rare in clinical practice and is often caused by sudden stress events or other diseases such as snoring. Its pathogenesis and treatment are different from PNE. PNE is a multifactorial disease related to genetics, and its pathogenesis is not fully understood. There are not many research and review articles on its pathogenesis. In recent years, there has been significant progress in the epidemiology and pathogenesis of PNE. The following is a summary.

Prevalence of Enuresis in Children, Adolescents, and Young Adults Diagnosed With Attention Deficit Hyperactivity Disorder.

Background Enuresis, or bedwetting, is a common condition affecting millions of children worldwide. This can be a source of distress for both children and their families. Children, adolescents, and young adults with attention deficit hyperactivity disorder (ADHD) are at risk of developing enuresis. They have difficulties with executive functioning, including impulse control and emotional regulation. These difficulties may contribute to the development of enuresis, as individuals may struggle to recognize the urge to use the bathroom or have difficulty controlling their bladder during sleep. Objective To assess the prevalence of enuresis in children, adolescents, and young adults with ADHD and determine whether the presence of other behavioral disorders such anxiety, depression, learning disabilities, and autism comorbid with ADHDis a risk factor for developing enuresis. Method A case-control studyincluded 213 children, adolescents, and young adults aged seven to 23 years, with 139 males and 74 females. A total of 161 participantswere diagnosed with ADHD. Data collection consisted of a semi-structured interview conducted with each participant or theirparents in person during their visit to Developmental Pediatric Clinics and Psychiatry Clinics. The questions were designed to collect data on the participant's ADHD diagnosis, enuresis history, other behavioral disorders, such as anxiety, depression, and learning difficulties, and any relevant medical or developmental history. The interview lasted approximately 30 minutes. Results Children, adolescents, and young adults with ADHD had a significantly higher prevalence of enuresis than the control group (13.6% vs. 0.9%, p = 0.01). Other behavioral disorders comorbid with ADHD did not pose a statistically significant risk for the development of enuresis (p = 0.36). Conclusions This study supports that children, adolescents, and young adults diagnosed with ADHD are more likely to have enuresis than those without ADHD. This finding is consistent with previous research and emphasizes the importance of a thorough evaluation and comprehensive treatment plan for individuals with ADHD.

Interventions for Enuresis in Children and Adolescents: An Overview of Systematic Reviews.

Enuresis is an involuntary and intermittent loss of urine during sleep, and its treatment can be done by pharmacological and non-pharmacological strategies. To conduct an overview to carry out a survey of the systematic reviews about treatment options for children/adolescents with enuresis. Databases used were Cochrane Library, PROSPERO, MEDLINE/PubMed, EMBASE, LILACS/BVS, PEDro, SciELO and Google Scholar. Any type of intervention for the treatment of enuresis in children/adolescents was selected by two independent researchers. Data extraction was done by two independent researchers. The risk of bias was assessed using Risk of Bias in Systematic Reviews (ROBIS) and A MeaSurement Tool to Assess Systematic Reviews (AMSTAR-2). Seven systematic reviews were included. According to ROBIS, three reviews had a low risk of bias, while the others had a high risk of bias. Based on AMSTAR-2, four systematic reviews were of moderate quality, two were low quality, and one was critically low quality. There is moderate confidence that the use of desmopressin plus an anticholinergic agent increases the chance of complete response compared to desmopressin alone. Neurostimulation may increase the risk of responses ≥50% and ≥90% compared to the control group. Likewise, it appears that electrical stimulation is superior to placebo about the chance of response ≥50%. In addition, there is clinical relevance in reducing enuresis episodes per week when neurostimulation is used compared to control groups.

Constipation: A Pristine Universal Pediatric Health Delinquent.

Constipation suffered by children is a global public health problem. Functional constipation (FC) brings about deteriorating effects in the children's lives who suffer from it. The risk factors for the development of constipation include the consumption of a diet low in fiber and high in calories (such as the consumption of fast food), a sedentary lifestyle with a lack of exercise, a family history of constipation, and emotional and psychological stress endured by children in their families. It is one of the most common causes of stomachaches in children. FCmay lead to fecal incontinence (FI), anal fissures, recurrent urinary tract infections (RUTI), and enuresis in children. Severe constipation may result in stool becoming rock-hard and inflexible in the rectum, which is clinically identified as fecal impaction. It is imperative to perform clinical evaluation and treatment, including pharmacological (the use of stimulant and osmotic laxatives) and non-pharmacological (education, changes in diet, intervention to promote positive behavior and address any emotional issues, toilet training, and physiotherapy for the pelvic floor) interventions. In the case of refractory patients, neuromodulation, the irrigation of the anal canal, and surgical management may be needed. It is essential to lead a healthy, stress-free lifestyle with plenty of exercise and a balanced diet rich in fiber (such as fruits and vegetables) so children can have regular bowel habits and thrive.

Enuresis of Children in A Hospital Environment: Epidemiological, Diagnostic and Therapeutic Aspects in The Thies Region

Enuresis of Children in A Hospital Environment: Epidemiological, Diagnostic and Therapeutic Aspects in The Thies Region

Logistic regression analysis of risk factors influencing childhood enuresis: a comprehensive survey study.

To identify risk factors associated with childhood enuresis. We conducted a retrospective analysis of 146 children aged 6 to 13 years diagnosed with enuresis at Anhui Province Children's Hospital between June 2020 and June 2023. Children were categorized based on bedwetting frequency: those with less frequent episodes (once a week to twice a month) were placed in the mild group (60 cases), and those with frequent episodes (two or more times per week) were placed in the severe group (86 cases). We compared demographic data, family histories, and personal characteristics between the groups and performed logistic regression to determine significant risk factors. The analysis revealed that a stubborn personality, nocturnal polyuria, sleep-wake disorders, and bladder dysfunction significantly increased the risk of enuresis (P < 0.05). These findings underscore the importance of a holistic approach in evaluating psychological aspects, nocturnal urination patterns, sleep quality, and bladder health in managing enuresis. The study identifies stubborn personality, nocturnal polyuria, sleep-wake disorders, and bladder dysfunction as independent risk factors for childhood enuresis. Understanding these factors is crucial for developing targeted interventions that can enhance the management and outcomes of enuresis. Future research should explore the interrelationships among these factors to refine preventive and therapeutic strategies for early childhood enuresis.

Diurnal rhythm of urinary aquaporin-2 in children with primary monosymptomatic nocturnal enuresis.

Nocturnal enuresis can be frustrating for children and their families as the child ages. Our aim is to evaluate urine aquaporin 2 (AQP-2) as a noninvasive biomarker of water balance in children with primary monosymptomatic nocturnal enuresis (PMNE). The study included 90 children; sixty-eight children suffering from PMNE aged (9.57 ± 2.16) years and 22 healthy children with good toilet control, matched sex and age. All enuretic children were subjected to complete history taking, clinical evaluation, and bed wetting diary. Serum arginine vasopressin (AVP) and urine AQP-2 were tested in the morning (at 9-11 am) and evening (at 9-11 pm). Blood urea, creatinine, Na, glucose, urine osmolality, Ca/Cr, Alb/Cr and specific gravity were tested simultaneously. Serum AVP, urine AQP-2, and urine osmolality were statistically lower in patients than controls. Patients had a significantly lower level of night serum AVP concentrations, urine AQP-2, and urine osmolality than the corresponding morning level. Urine AQP-2 was significantly correlated with urine osmolality (p < 0.05). AQP-2 had a sensitivity of 90% and a specificity of 70%. However, no statistically significant correlation was found between serum AVP and urine AQP-2. Primary monosymptomatic nocturnal enuresis in children could be associated with reduction of urine excretion of AQP-2 at night. Urine AQP-2 is significantly correlated with urine osmolality. Therefore, it may be a noninvasive biomarker of hydration status in children with PMNE, with good sensitivity and specificity.

Nocturnal enuresis in children

Nocturnal enuresis, defined as urinary incontinence during sleep at least twice weekly for three consecutive months in children over 5 years old, is a common childhood condition that significantly impacts both children and their families. This review examines the classification, etiology, pathophysiology, evaluation, and treatment options for nocturnal enuresis. The condition is classified as either monosymptomatic or non-monosymptomatic, and primary or secondary, with primary enuresis accounting for 80% of cases. The pathophysiology involves three main mechanisms: nocturnal polyuria, high arousal threshold, and bladder dysfunction. Genetic factors play a significant role, with a strong familial component following an autosomal dominant pattern. Evaluation includes detailed medical history, voiding diary, physical examination, and basic laboratory tests. Treatment approaches are divided into non-pharmacological (including behavioral modifications, motivational therapy, and alarm therapy) and pharmacological interventions (primarily desmopressin, tricyclic antidepressants, and anticholinergic drugs). While alarm therapy shows the highest long-term success rates (65-75%), combination therapy may be necessary for treatment-resistant cases. This review emphasizes the importance of individualized treatment approaches and family support in managing childhood nocturnal enuresis effectively.