Enuresis In Children Research Articles

Assessment of Nocturnal Enuresis Management in Children in the Advanced Diagnostic Center in Khartoum State

Nocturnal enuresis is defined as nighttime bedwetting in children five years of age or older in the absence of neurological or structural problems affecting the bladder. A wide variety of interventions are used to treat nocturnal enuresis include simple behavioral intervention, enuresis alarm, and pharmacological treatment—the aim of the study to assess the management of nocturnal enuresis in children. A prospective cross-sectional study included 150 children attend the advanced diagnostic center. Data collected by direct interview questionnaire was tested –coded and analyzed by SPSS version 20 in tables and graph &excel. The result of this study showed that the highest treatment adopted was simple-cognitive behavioral therapy (87%), with the highest (94.7%) of patient surveyed adopted lifting and awaking technique,(38%) of patient surveyed have taken imipramine, (26%) of patient surveyed have taken 75mg dose of imipramine, (37%)of patients surveyed had a full response from imipramine therapy. The study showed that the first-line treatment that is needed is simple-cognitive behavioral therapy with instruction regarding diet and fluids, and it is very useful. The main drug was used in the treatment of nocturnal enuresis is imipramine with a dose of 75mg.

Lower urinary tract symptoms in adolescent girls: a questionnaire-based study

ObjectiveTo determine the prevalence of lower urinary tract symptoms (LUTS) in female adolescent population. Study designWe performed a questionnaire-based study in nine randomly selected high schools in our country. Our primary aim was to evaluate the prevalence of certain LUTS in adolescent girls: frequency, urgency, nocturia, feeling of incomplete bladder emptying, dysuria, and urinary incontinence. The secondary aim was to investigate the effect of some possible risk factors on LUTS prevalence. Statistical analysis was performed using SPSS Statistics Programme. Descriptive statistics were calculated. Non-parametric test was used for comparison of numerical and Pearson’s Chi-square test for categorical data. Logistic regression was performed to identify the independent prognosticators for LUTS presence. Statistical significance was set at p < 0.05. ResultsWe included 2745 adolescent girls. Their average age was 16.8 ± 1.2 years and 17.8 % of them regularly experienced at least one LUTS. The frequency of occasional LUTS was even higher. The most common symptom was urinary incontinence (5.9 %), followed by frequency (5.1 %), feeling of incomplete bladder emptying (4.8 %), urgency (3.1 %), and nocturia (2.6 %). Risk factors for LUTS presence were girls’ school success, frequent pelvic pain, previous cystitis, history of night enuresis in childhood, and sexual intercourses in the last three months. ConclusionsAccording to our results, the prevalence of LUTS amongst female adolescents is high and can be associated with certain risk factors. In our opinion, further research should be directed into determining the effect of LUTS on adolescents’ quality of life.

A study of the factors causing secondary nocturnal enuresis in children.

Nocturnal enuresis is still perceived as a shameful condition and kept as a secret. But there is nothing shameful about bedwetting. Secondary nocturnal enuresis mostly caused by psychosocial factors that may generates psychological problems for the child, especially evident as a deterioration of self-esteem. A descriptive study of secondary nocturnal enuresis to find out what psychological stressful factors that related and lead the child to have secondary nocturnal enuresis. A prospective study included a sample of 45 children with secondary nocturnal enuresis, whom attended to child psychiatric department were evaluated for the age of primary control, age at which the secondary nocturnal enuresis occurred, sex, residence, either urban or rural aria, family history of primary or secondary nocturnal enuresis in parents and sibling, medical illnesses, history of stressful condition, immigration from their houses, death in family, one of the family arrested, birth of a new baby, family problems like divorce, or others emotional or traumatic event, how the family face the problem and how the child feels toward himself. Of the 45 children, the mean age of primary control of day and night urination was 2.5 years the majority of secondary nocturnal enuresis between 5-10 years girls were slightly more affected, most of them from urban aria, no significant history of secondary enuresis in their parents and siblings, thirty eight children (84.4%) had psychological problems before return to secondary nocturnal enuresis from them 14 children (31.1%) had history of traumatic stressful event, eight children (17.8%) had history of immigration from their houses six children (13.3%) had history of death in family. Seven children (15.6%) had medical illnesses that lead to secondary nocturnal enuresis. Eight children (17.8%) have been punished by their family, thirty seven children (82.2%) were enforced and 27 children (60%) had social embarrassment and inferiority feeling. Conclusion: Secondary nocturnal enuresis was predominantly seen in school aged children after stressful traumatic events. Who need psychological support?

Chapter 21 - Nocturnal enuresis in children: The role of arginine–vasopressin

Nocturnal enuresis is the involuntary pass of urine during sleep beyond the age of 5 years. It is a common condition in childhood and has an impact on the child's well-being. Research into the pathophysiology of the condition in the last decades has led to a paradigm shift, and enuresis is no longer considered a psychiatric disorder but rather a maturation defect with a somatic background. An excess urine production during sleep is a common finding in children with enuresis and disturbances in the circadian rhythm of arginine-vasopressin (AVP) is found in the majority of children with nocturnal polyuria. Children with enuresis and nocturnal polyuria lack the physiologic increase in AVP levels during sleep and treatment with the AVP analogue desmopressin can restore this rhythm and lead to dry nights. The reasons for this aberrant circadian AVP rhythm are not established. Furthermore, not all children with enuresis and nocturnal polyuria can be successfully treated with desmopressin suggesting that factors beyond renal water handling can be implicated such as natriuresis, hypercalciuria, and sleep-disordered breathing. The advances in the research of the genetic background of the condition may shed further light on the enuresis pathophysiology.

Association between Rapid Maxillary Expansion and Nocturnal Enuresis in Children: A Pilot Study for a Randomized Controlled Clinical Trial

Objectives: This pilot study was conducted to test the protocol of a randomized controlled trial evaluating whether rapid maxillary expansion (RME) can relieve nocturnal enuresis (NE) and improve breathing in children, after ruling out a placebo effect, and investigating whether the effects of RME and NE are related to the morphology of the upper airway. Methods: Seventy 6–15-year-old patients with NE were assessed for eligibility (e.g., constricted maxilla). Enrolled subjects were randomized to immediate treatment with RME (Group 1) or to have the same treatment (RME) delayed for at least six weeks (Group 2). Outcomes comprised the number of wet nights per week, the nocturnal urine production, and the scores of a pediatric sleep questionnaire at baseline, after active treatment (Group 1) or delayed treatment (Group 2), and after 3 months’ retention. Cone beam computed tomographies were taken at baseline and after retention. Results: Six patients were randomized: three in each group. In four of six patients, the number of wet nights per week decreased. Moreover, in responders, nocturnal urine production was reduced following RME. Conclusions: This pilot study suggested that RME might reduce the severity of NE and showed that the protocol of this randomized controlled clinical trial was appropriate.

The impact of adenotonsillectomy on monosymptomatic primary nocturnal enuresis in children with obstructive sleep apnea syndrome

Objectives: To analyze the outcome of monosymptomatic primary nocturnal enuresis (MPNE) after adenotonsillectomy in children with obstructive sleep apnea syndrome (OSAS). Methods: The study included 74 MPNE children with OSAS qualified for an adenotonsillectomy procedure. MPNE was assessed prior to surgical procedure as well as 3 and 6 months after surgery. In addition to polysomnographic parameters, serum antidiuretic hormone (ADH) and brain natriuretic peptide (BNP) levels were measured preoperatively and 3 months postoperatively. Results: The mean age was 9.8 years and the mean number of nocturnal wetting weekly was 4.1. Thirty-eight percent of patients had family history of MPNE. All the patients underwent a successful adenotonsillectomy. Nocturnal enuresis was still reported in 18% of children 6 months after adenotonsillectomy. An increased risk of MPNE was significantly demonstrated in children with high obstructive apnea-hypopnea index (O-AHI), high oxygen desaturation index (ODI), high frequent nocturnal enuresis and family history. After surgery, ADH levels were significantly lower, whereas BNP levels were significantly higher in non-resolution children. Univariate analysis showed that higher O-AHI, higher ODI, severe enuresis, low serum ADH and higher serum BNP levels were indicative of persistent nocturnal enuresis. Multivariate analysis showed that higher ODI and higher BNP levels are independent prognostic markers for MPNE. Conclusions: Adenotonsillectomy in MPNE children with OSAS is an effective treatment for resolution of MPNE. Also, higher ODI caused by apnea and elevated serum BNP levels are the most important factors affecting the outcome of MPNE patients. Level of evidence: Not applicable for this multicentre audit.

The Treatment of Nocturnal Enuresis in Children: An Overview

Background: The aim of this review was to compare the efficacy of acupuncture therapy in the treatment of nocturnal enuresis with placebo acupuncture or oral pharmacological treatment based on randomized controlled trials. Materials and Methods: Two independent researchers screened the meta-analysis articles on the effect of treatment nocturnal enuresis in children. The databases included Scopus, EMBASE, Cochrane, Web of Science, and Medline, with no time and language restrictions from the beginning up to March 10, 2020. Results: The first meta-analysis showed that therapy with the combination of desmopressin and anticholinergics (combination therapy) was significantly better than desmopressin monotherapy. The second meta-analysis showed that structured withdrawal from desmopressin treatment compared with the abrupt withdrawal results in a significantly better relapse-free rate (pooled RR: 1.38; 95% confidence interval [CI]: 1.17–1.63; P=0.0001). The third meta-analysis reported a 31% rate of successful treatment for rapid palatal expansion, which is promising compared to the spontaneous cure rate. In the fourth meta-analysis, the pooled data showed a significant difference between acupuncture and meclofenoxate therapy (OR=2.81). No significant difference was observed between acupuncture, desmopressin (OR = 1.57), imipramine hydrochloride (OR = 1.71), and oxybutynin (OR = 3.57). In the fifth meta-analysis, a statistically significant difference was observed between the frequency of enuresis per week (P < 0.001), the number of patients with clinical response (P Conclusion: Therapy with the combination of desmopressin and anticholinergics (combination therapy) produced significantly better results than desmopressin monotherapy. The findings showed the positive effects of acupuncture therapy and rapid palatal expansion on nocturnal enuresis in children.

Antiepileptic Drugs-Induced Enuresis in Children: An Overview.

Objective: To evaluate enuresis-induced antiepileptic drugs in children. Data Sources: A PubMed search (1917 to July 2020) was performed using the following keywords and associated medical subject headings: antiepileptic drugs, enuresis, pediatric population, drug-induced enuresis, and epilepsy. Study Selection and Data Extraction: The search was conducted to find the role of antiepileptic drugs-induced enuresis in children in studies published in English. Data Synthesis: Enuresis or bedwetting is an underreported adverse drug reaction of antiepileptic drugs. Owing to that fact, it is a condition that is outgrown with age and also could cause embarrassment. As antiepileptic drugs sometimes need to be taken for a long duration until epilepsy relapses, the occurrence of enuresis in this situation can be troublesome for both the child and the caretaker. Even though enuresis is proposed to have a significant effect on the child's psychology, it is still considered to be a condition that is outgrown with age. This article includes a review of antiepileptic drugs reported to have caused enuresis in children. Conclusions: If a child develops enuresis as an adverse drug reaction, this adds further challenges to their life. A better understanding of this potential adverse effect may help prevent unwanted stress. Though the exact mechanisms are not known, the hypothesis generated is from the occurred cases, most of which relapsed when the drug was withdrawn. Considering the gravity of epilepsy in children, more detailed studies need to be conducted on this adverse effect to ensure a safe and effective treatment in children.

Body-Worn Versus Bell-and-Pad Alarm Device for the Management of Monosymptomatic Nocturnal Enuresis in Children: A Randomized Controlled Trial.

The purpose of this study was to compare the effectiveness of bell-and-pad alarm therapy to body-worn alarm therapy for the management of monosymptomatic enuresis in children 6 to 16 years of age. A prospective, randomized, adaptive clinical control trial. The sample comprised 86 children who attended a continence clinic for treatment of monosymptomatic enuresis and met the criteria for enuresis alarm therapy as per International Children's Continence Society (ICCS) guidelines. Subjects were randomly allocated to an experimental group (body-worn alarm, n = 41) or a control group (bell-and-pad alarm, n = 45). The study setting was a single-site specialist continence service in regional Victoria, Australia. Treatment was administered in the child's home. Alarm therapy was administered by the child and/or parent for an initial period of 8 weeks at which time the child underwent a review with the continence nurse specialist. If the child had achieved 14 consecutive dry nights, the therapy was deemed successful and ceased. Children who had not become dry continued therapy for a further 8 weeks up to a maximum of 16 weeks, with a final review was instituted. Each child kept a diary for the duration of alarm therapy to report on frequency of wet/dry nights, times of alarm, response to alarm, and response to sensation to void (without alarm). The 2 types of alarm devices were compared with respect to categorical variables using dichotomous cross-tabulations and χ tests of independence based on the most positive outcome versus the other outcomes. Dryness in accordance with the criteria outlined by the ICCS guidelines was achieved in 18 children (43.9%) in the body-worn alarm group versus 29 children (64.4%) in the routine (bell-and-pad) group (P = .056). The bell-and-pad alarm performed better on 7 out of the 9 indicators, including the primary outcome measure of the child attained dryness for 14 nights or more, nightly alarm use, alarm woke child, alarm woke parent (P = .022), false (positive) alarms (P = .039), child turned alarm off and went back to sleep (P = .003), and child was compliant with alarm use. The body-worn device produced higher proportions of the most positive outcomes for 2 of the 9 indicators: relapse (P = .076) and false (negative) nonalarms (P = .066). Study findings suggests that the bell-and-pad alarm is preferable to the body-worn alarm. Additional research is recommended using other body-worn alarm devices across a larger population in order to establish the more definitive findings needed for clinical decision-making.

Disposable diaper overuse is associated with primary enuresis in children

This research investigated the association between prolonged disposable diaper (DD) wearing in infancy and primary enuresis (PNE). As a case–control study, we collected data from 376 children with enuresis and 379 healthy children who were sex- and age-matched at three tertiary care institutions in mainland China from August 2017 to July 2018. The results of adjusted logistic regression showed the odds ratios (95% confidence intervals) for PNE across the categories of age of daytime DD use cessation were as follows: ≥ 25 months: 1.00, 18–24 months: 0.25 (0.17–0.37), and ≤ 17 months: 0.11 (0.06–0.20), independent of age, mother education, residence, toilet training approach, breastfeeding duration, UTI, constipation, anaphylactic disease and family history. After a similar multivariable adjustment, increased age of daytime DD use (per-month) had a positive correlation with PNE, OR = 1.17, 95% CI 1.13–1.20 and non-linear relationship was detected, whose point was 21 months (the effect sizes and the 95%CI on the left and right sides of inflection point were 1.04 (0.99–1.10), P = 0.131 and 1.25 (1.18–1.31), P < 0.001). Subgroup analysis found that the effect of duration of disposable diaper exposure for each additional month, those children had accepted assisted infant toilet training/elimination communication (AITT/EC) practice had a lower risk of PNE (OR = 1.08, 95% CI 1.04–1.12), compared with those without AITT/EC practice (OR = 1.20, 95% CI 1.14–1.27), P for interaction < 0.001. In conclusion, the children diagnosed with primary enuresis after age 5 stopped using disposable diapers at daytime later than the control group. Association between duration of DD exposure and the risk of childhood enuresis is modified by AITT/EC practice. Timely cessation use of disposable diaper and practice AITT/EC may shorten the time to nocturnal continence, and the prospective cohort studies are needed to verify the discoveries.

Application of Machine Learning Techniques for Enuresis Prediction in Children.

As a subset of artificial intelligence, machine learning techniques (MLTs) may evaluate very large and raw datasets. In this study, the aim is to establish a model by MLT for the prediction of enuresis in children. The study included 8,071 elementary school students. A total of 704 children had enuresis. For analysis of data with MLT, another group including 704 nonenuretic children was structured with stratified sampling. Out of 34 independent variables, 14 with high feature values significantly affecting enuresis were selected. A model of estimation was created by training the data. Fourteen independent variables in order of feature importance value were starting age of toilet training, having urinary urgency, holding maneuvers to prevent voiding, frequency of defecation, history of enuresis in mother and father, having child's own room, parent's education level, history of enuresis in siblings, consanguineous marriage, incomplete bladder emptying, frequent voiding, gender, history of urinary tract infection, and surgery in the past. The best MLT algorithm for the prediction of enuresis was determined as logistic regression algorithm. The total accuracy rate of the model in prediction was 81.3%. MLT might provide a faster and easier evaluation process for studies on enuresis with a large dataset. The model in this study may suggest that selected variables with high feature values could be preferred with priority in any screening studies for enuresis. MLT may prevent clinical errors due to human cognitive biases and may help the physicians to be proactive in diagnosis and treatment of enuresis.

Re: Efficacy of the novel selective β3‐adrenoreceptor agonist vibegron for treatment‐resistant monosymptomatic nocturnal enuresis in children

Re: Efficacy of the novel selective β3‐adrenoreceptor agonist vibegron for treatment‐resistant monosymptomatic nocturnal enuresis in children

Nocturnal enuresis among children in Morogoro region in Tanzania: A cross-sectional survey

Background: Enuresis is common childhood disorders which affecting quality of life of children and causing significant psychosocial disturbances to children and their families. This condition has been widely reported globally with increasing data from sub-Saharan African region. In Tanzania there is no reports on its magnitude and therefore this study was carried out with the aim of determine the prevalence of this condition among children in Tanzania.Methods: This was a community based cross-sectional study conducted among children aged between 5 and 14 years recruited from 12 streets in Morogoro Municipality in Tanzania. Standardized Swahili questionnaire was used to collect data including socio-demographic details of parents, children and presence of enuresis. Socio-demographic data included age of the child, sex, level of education of the parents, education of the child, presence of bed wetting, history of enuresis in the family.Results: Five hundred and ten children were recruited into this study out of which 271 (53.1%) were females and mean age of study participants was 9±2.8 years. Enuresis was noted in 19% (97/510) of children, 68% (66/97) and 32% (31/97) had primary and secondary enuresis respectively. Significantly higher prevalence rates of enuresis were noted for children aged below 8 years 26.4% (43/162) and those with family history of enuresis 47% (18/38) with p values of 0.01 and &lt; 0.001 respectively. Forty-one (42.3%) out of 97 respondents whose children had enuresis reported to have punished their children and only 21.4% (20/97) reported to have sought treatment for their children.Conclusions: Enuresis is common among children in Tanzania particularly those with positive family history. Punishment to children with enuresis was noted in this study and only one in five parents/guardians sought treatment for their affected children. Therefore, there is a need for initiatives for raising community awareness about enuresis in Tanzania&#x0D; Key words: Enuresis in children, prevalence of enuresis in Tanzania, factors affecting enuresis in children.

Urinary incontinence in female university students.

We aimed to determine the prevalence of urinary incontinence (UI) in nulliparous female university students and to provide an overview of risk factors associated with urinary continence. A total of 1,397 female university students aged 18-28years were enrolled into this cross-sectional questionnaire study. The self-administered questionnaires, the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Overactive Bladder V8 (OAB-V8), demographics, and general characteristics were recorded. The frequency, type, and severity of urinary incontinence and related factors were evaluated. The mean age of the students was 20.27 ± 1.69years. The prevalence of UI in female university students was 18.4% (n = 258). ICIQ-SF total score was 0.85 ± 2.11 (0-14). OAB-V8 total score was 5.97 ± 5.35 (0-40) and 27.0% of participants had scores of ≥8. Elevated BMI, childhood enuresis, constipation, exercising, positive family history for UI, accommodation in a dormitory, and holding urine at school are risk factors associated with UI in female university students. We demonstrated that UI is a common condition among female university students. The identification of the associated risk factors will help to further raise the knowledge and awareness of the problem, and preventive strategies may be proposed to young women to improve the quality of life and psychological well-being.

Neurophysiological aspects of enuresis in children

Introduction. Enuresis is a pathological condition, manifested by involuntary urination during sleep or in the wakeful state. It is believed that enuresis is associated with unformed or impaired self-control skills for emptying the bladder. The significance of the problem is determined by the widespread prevalence of pathology, social and psychological maladaptation of children with enuresis. An important role in this plays the development of their personality by an accentuated type often, difficult adaptability, and lack of ability to integrate into the team, especially into the semi or closed type. According to modern concepts, enuresis can be caused by the following reasons: delayed maturation of the nervous system, urological pathology and urinary tract infection, impaired activation reaction during sleep, impaired rhythm of secretion of antidiuretic hormone, adverse heredity, psychological factors and stress. The results of Russian and foreign scientists studies revealed the polyetiological character of enuresis and the impossibility, in most cases, of identifying its obvious cause. This explains the relatively wide variability of outcomes: from spontaneous cure to apparent resistance to all existing treatments. The significant prevalence of enuresis, the relative severity of this pathology and the lack of effective treatment methods necessitate the search for alternative methods of therapy or fundamentally new approaches to using existing ones, which is impossible without a thorough study of this disease etiopathogenesis.The goal of research — is to study the neurophysiological characteristics of enuresis in children.Materials and methods. Prospective controlled study was conducted in Kazan State Medical Academy — a branch of the RMACPE (Kazan) in the period 2003–2019 years. To study enuresis mechanisms we carried out a comprehensive clinical-electroneurophysiological examination of 93 children aged 5 to 15 years, suffering from bedwetting. The control group consisted of 40 healthy children who were comparable in age and gender to those in the main group. All patients underwent a comprehensive examination, which included the study of complaints, anamnesis, clinical and electroneurophysiological research.Results. Clinical examination of children with enuresis revealed signs of minimal cerebral dysfunction. An electrophysiological examination made it possible to determine an increase in the refl ex excitability of brain stem structures against the background of a decrease in downward inhibitory control.Conclusion. The predominance of excitation processes over inhibition in the central nervous system is mainly observed in children with enuresis. The weakness of the inhibitory mechanisms due to constitutional factors, pathology of the nervous system that took place earlier, allows making an assumption about the diffuse nature of the disorders of the nervous system in this urination disorder.

Efficacy of Vibroacoustic Stimulation Treatment of Enuresis in Children

Background and Aim: Functional voiding disorders (FVDs) are common problems in children. The effect of vibroacoustic therapy has not been examined in children with FVDs. The aim of this study was to investigate the efficacy of vibroacoustic therapy for treatment of FVDs in children.Methods: Seventy-eight children were included in this prospective study. Dysfunctional voiding score (DVS) and nocturnal enuresis (NE) score were measured before and after vibroacoustic treatment. The success of vibroacoustic therapy use was evaluated according to the percentage of decrease in DVS and NE scores relative to the pre-treatment values. Descriptive and analytic statistical methods were applied for data analysis using SPSS software version 22.0.Results: The mean age of the participants was 8.65±3.11 years, and half of them were boys. Of 78 patients, 60 were school-aged and 18 were preschool-aged children. A significant difference was noticed between DVS score (p < 0.01) and NE score (p < 0.01) before and after vibroacoustic therapy in school-aged children. No significant correlation was observed between the success of vibroacoustic therapy and factors such as enuresis type (primary/secondary), applied form of pharmacologic therapy, baseline DVS and NE score, and the presence of a positive family history and expressed through percentage of decrease in DVS and NE scores in school-aged children.Conclusion: The results of the present study showed the positive effect of the vibroacoustic therapy in school-aged children with functional voiding disorders. It is, however, necessary to conduct further prospective studies in order to confirm its effectiveness and determine its long-term results. Keywords: Child; Enuresis; Urinary bladder.

Efficacy of the novel selective β3-adrenoreceptor agonist vibegron for treatment-resistant monosymptomatic nocturnal enuresis in children.

Efficacy of the novel selective β3-adrenoreceptor agonist vibegron for treatment-resistant monosymptomatic nocturnal enuresis in children.

Alarm interventions for nocturnal enuresis in children.

Alarm interventions for nocturnal enuresis in children.

The Prevalence of Nocturnal Enuresis among Patients with Vesicoureteral Reflux

Background: To identify the prevalence and other associated factors of nocturnal enuresis in children with vesicoureteral reflux undergoing surgical interventions.Methods: This is a cross-sectional study were the medical records of 40 children with confirmed vesicoureteral reflux were reviewed. Additionally, parents were asked to fill out a questionnaire inquiring about presence, onset &amp; course of nocturnal enuresis as has been defined according to ICD-10.Results: Among the 40 children, 22 children (55%) had nocturnal enuresis before any surgical intervention. However; gender, family history of bedwetting, renal hydronephrosis on ultrasound, positive urine culture, and pre-op creatinine level were found to have statistically insignificant association with nocturnal enuresis. After surgical management only 13 (32.5%) children experienced nocturnal enuresis.Conclusion: This study can conclude that there is a weak correlation between NE and VUR in patients undergoing surgical intervention. Also, the surgical management of VUR did not significantly affect the prevalence of NE. However, it is an essential problem for both families and children in Jordan for which specific guidelines should be developed.

Review of Clinical Studies for Korean Medicine Treatment on Nocturnal Enuresis in Children

Review of Clinical Studies for Korean Medicine Treatment on Nocturnal Enuresis in Children