Frequency Of Nocturnal Enuresis Research Articles

Posterior tibial nerve stimulation versus desmopressin in treating children with primary mono-symptomatic nocturnal enuresis. A randomized clinical trial

ABSTRACT Objective Assessment of the efficacy of Posterior Tibial Nerve Stimulation (PTNS) versus Desmopressin in treating Primary Mono-symptomatic Nocturnal Enuresis (PMNE). Patients and methods This randomized clinical trial was conducted at the Urology department of Abo Elreesh pediatric hospital, Cairo University on 80 children, aged between 5 and 13 years old, diagnosed to have PMNE between June 2020 and November 2020. Children were divided into two equal groups; those who underwent PTNS (as one session per week for 12 weeks) (Group A) and those who received Desmopressin 0.2 mg. single evening dose for 12 weeks (Group B). Both groups were constructed to adhere to behavioral therapy and were statistically evaluated regarding the frequency of nocturnal enuresis (NE) before, after treatment, and after 1 month of follow-up. Results Both groups showed statistically significant improvement in the frequency of NE before and after treatment (p < 0.001), but there were no statistically significant differences between them (p = 0.763). There was a statistically significant relapse of NE frequency after 1 month of follow-up after completion of treatment in both groups (p < 0.001), with no statistically significant differences between the two groups (p = 0.075). Conclusion Posterior tibial nerve stimulation and Desmopressin are viable treatment options for children with primary mono-symptomatic nocturnal enuresis. However, relapse in some responders with time suggests the need for maintenance therapy.

PD06-09 EFFECTS OF DESMOPRESSIN PLUS PROPIVERINE FOR THE TREATMENT OF MONOSYMPTOMATIC PRIMARY NOCTURNAL ENURESIS IN CHILDREN

You have accessJournal of UrologyCME1 Apr 2023PD06-09 EFFECTS OF DESMOPRESSIN PLUS PROPIVERINE FOR THE TREATMENT OF MONOSYMPTOMATIC PRIMARY NOCTURNAL ENURESIS IN CHILDREN Do Gyeong Lim, Jeong Hoon Oh, Jiwon Ryu, Seong Hyeon Yu, Ho Seok Chung, Eu Chang Hwang, Kyung Jin Oh, Seung Il Jung, Taek Won Kang, Kwangsung Park, Dong Deuk Kwon, and Sun-Ouck Kim Do Gyeong LimDo Gyeong Lim More articles by this author , Jeong Hoon OhJeong Hoon Oh More articles by this author , Jiwon RyuJiwon Ryu More articles by this author , Seong Hyeon YuSeong Hyeon Yu More articles by this author , Ho Seok ChungHo Seok Chung More articles by this author , Eu Chang HwangEu Chang Hwang More articles by this author , Kyung Jin OhKyung Jin Oh More articles by this author , Seung Il JungSeung Il Jung More articles by this author , Taek Won KangTaek Won Kang More articles by this author , Kwangsung ParkKwangsung Park More articles by this author , Dong Deuk KwonDong Deuk Kwon More articles by this author , and Sun-Ouck KimSun-Ouck Kim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003230.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We evaluated the efficacy of a combination treatment of desmopressin and propiverine for treating children with monosymptomatic primary nocturnal enuresis. METHODS: A total of 53 children aged 6 to 15 years old with monosymptomatic nocturnal enuresis prospectively were enrolled in this study. Children with a minimum of 3 wet nights weekly were included in the study. Children were randomly assigned groups and treated with desmopressin 0.2mg, or a combination of desmopressin plus propiverine 10mg. Of these patients 43 (31 boys and 12 girls, mean age 8.4±2.5 years, range 4 to 13) were followed for more than 6 months. Efficacy was measured at 1, 3 and 6 months in terms of average enuretic frequency after treatment. RESULTS: Of the 43 children finally analysed 23 received combination therapy of desmopressin and propiverine and 20 received desmopressin alone. The frequency of nocturnal enuresis at baseline in monotherapy group and combination therapy was similar (5.45±1.57 vs 5.82±1.44). However, decrease of the nocturnal enuresis was significantly pronounced in combination group after 6 months treatment than in monotherpy group (1.8±1.01 vs 1.29±0.67). Combination therapy produced better outcomes than monotherapy in terms of number of nocturnal enuresis episode. The adverse event was minimal. CONCLUSIONS: Combination therapy with desmopressin plus propiverine for the treatment of monosymptomatic nocturnal enuresis was well tolerated, and gave significantly effective results in reducing enuresis episode than single therapy of desmopressin in children. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e159 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Do Gyeong Lim More articles by this author Jeong Hoon Oh More articles by this author Jiwon Ryu More articles by this author Seong Hyeon Yu More articles by this author Ho Seok Chung More articles by this author Eu Chang Hwang More articles by this author Kyung Jin Oh More articles by this author Seung Il Jung More articles by this author Taek Won Kang More articles by this author Kwangsung Park More articles by this author Dong Deuk Kwon More articles by this author Sun-Ouck Kim More articles by this author Expand All Advertisement PDF downloadLoading ...

A randomised, double-blind, placebo-controlled clinical trial found that a novel herbal formula Urox® (Bedtime Buddy®) assisted children for the treatment of nocturnal enuresis

BackgroundNocturnal enuresis or ‘bedwetting’, is a form of night-time urinary incontinence occurring in younger children. A diagnosis can be socially disruptive and psychologically stressful for a child. The most common strategies used by parents are waking the child during the night to use the bathroom and limiting the child's water intake before going to bed. Hypothesis/PurposeTo determine if a herbal capsule formulation taken once daily can reduce incidence and frequency of nocturnal enuresis in children. Study DesignThis randomised double-blind placebo-controlled trial evaluated the efficacy of an herbal medicine product to reduce the symptoms of nocturnal enuresis. Participants, aged between 6 and 14 years of age, were recruited from the community in Australia. They were randomised via computerised random-number generation at study enrolment to receive one or two oral capsules in the morning of either Urox® (Bedtime Buddy®) or placebo. The Paediatric Quality of life (Pin-Q) was used as a quality-of-life measure and waking wet, fluid intake and urinary urgency per week were monitored. ResultsForty-one children completed the trial with an attrition rate of 16%. There were more males (64.6%) compared to females (35.4%) and the mean age was 8.6 years. Forty-one point seven percentages (41.7%) of participants had improvements in bed wetting by two months which was a highly clinically relevant effect (Cohen's D = 0.98). The primary outcome found that there was a statistically significant reduction in NE (p = 0.034; CI 0.086–2.095) and between groups using longitudinal analysis (p = 0.04, Coefficient -1.12, CI 95% -2.20 - -0.04). In the secondary outcomes, urinary urgency reduced statistically significantly for the intervention (p = 0.002; a reduction of 18.3% difference for Bedtime Buddy compared to an increase of 3.7% for the placebo). ConclusionUrox® (Bedtime Buddy®) may assist children in reducing nocturnal enuresis compared to placebo. In addition, it may assist in reducing daily incontinence and urinary urgency.

Rapid Maxillary Expansion and Nocturnal Enuresis in Children and Adolescents: A Systematic Review of Controlled Clinical Trials.

Objectives To evaluate the effectiveness of rapid palatal expansion in the treatment of nocturnal enuresis among 6–18-year-old children and adolescents. Methods Comprehensive searches were carried out in 6 electronic databases (EBSCO, ProQuest, Clinical Key, Science Direct, SCOPUS, and OVID) and supplemented by additional manual searches in 4 orthodontic journals until June 2020. Randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) of children and adolescents aged 6–18 years old of both genders who underwent rapid palatal expansion and were considered unresponsive to previous conventional nocturnal enuresis treatment were included in this review. Risk of bias of individual trials was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) assessment tool for CCTs and the revised Cochrane Risk-of-Bias tool for RCTs (RoB 2). Results Four studies met all inclusion criteria and were finally included in this systematic review, of which one was an RCT and three were CCTs. Reduction in nocturnal enuresis frequency was reported in all included studies with varying rates and methods of reporting, but most studies reported a statistically significant reduction in the number of wet nights per week. The average range of becoming completely dry 1 year after treatment with an RME was 0%–60%. Also, there was a statistically significant correlation between an improvement in bedwetting and an increase in nasal volume after the use of RME. Conclusion A rapid palatal expansion device may be considered as an alternative treatment option of the nocturnal enuresis condition with guarded prognosis when other treatment modalities have failed.

Therapeutic Efficacy of Hydrochlorothiazide in the Primary Monosymptomatic Nocturnal Enuresis of Children

Abstract Background: Nocturnal enuresis is a symptom with probably multiple etiologic factors and a high prevalence. Conventional therapies is expensive and complicated, since the effect of calcium on voiding dysfunction was approved. Therefore, to the current study aimed at evaluating the therapeutic effect of hydrochlorothiazide on primary monosymptomatic nocturnal enuresis (PMNE). Methods: The current study was conducted based on the interviews with patients. Morning urine test was evaluated in children with PMNE detection and specific gravity < 1010 enrolled to the study (110 children comprised of 57 cases and 53 controls). Children were divided into 2 groups; in the case group, hydrochlorothiazide (tablet 1 mg/kg and maximum 50 mg) was administered in the morning and the control group was only given necessary training about enuresis. For 3 times and with 1 month interval (based on a predetermined questionnaire) the frequency of nocturnal enuresis was checked. Data were transferred into SPSS program and the therapeutic effect of hydrochlorothiazide on primary monosymptomatic nocturnal enuresis was investigated. Findings: There was a statistically significant difference regarding the frequency of nocturnal enuresis between the 2 groups (P = 0.0001). Also, both groups were matched by age (P = 899) and gender (P = 607). Conclusions: Hydrochlorothiazide can be used as an effective and safe therapeutic option for treatment of primary monosymptomatic nocturnal enuresis.

Nocturnal Enuresis Frequency in Children and Anxiety-Depression Risks of Parents

Objective: In this study, we aimed to detect the prevalence of the monosymptomatic nocturnal enuresis (MSE) in the children attended to our clinics and to detect the relationship between enuresis and social tendencies, anxiety and de­pression risks of the parents. Methods: Our study was performed with 133 children aged between 5-16 years and with their parents who admitted to Ankara Numune Training and Research Hospital outpatient clinics. The children’s MSE were confirmed with voiding dysfunction scoring system scale. For the parents Hospital Anxiety and Depression Scale and Fatih Social Tendencies Scales (FSTS) were conducted. Results: MSE frequency was found as 37.6% (n=50). Enuresis was observed more frequently in the crowded families with low socioeconomic status and low parent education level. Risk of MSE in children was found to be increased 5.5 times in whom parents have also MSE. High depression score of father was found to be related with MSE in child (p=0.038). Conclusion: Enuresis is a condition that decreases the life quality of the children and their parents and increases the level of anxiety. Family physicians have important mission for prevention of the disease related with their biopsychoso­cial approach.

Desmopressin versus Oxybutynin for Nocturnal Enuresis in Children in Bandar Abbas: A Randomized Clinical Trial

BackgroundNocturnal enuresis is among the most common disorders in children. Several pharmacological and non-pharmacological treatments are available for nocturnal enuresis. Studies for reaching the best pharmacological treatment for this disorder are continuing.ObjectiveTo compare the effectiveness and safety of Desmopressin and oxybutynin for treatment of nocturnal enuresis in children from Bandar Abbas in 2014.MethodsThis randomized controlled trial was conducted in 2014 and participants included 66 children with nocturnal enuresis who were more than 5 years old. Patients were randomly assigned into two groups. The first group received 120 microgram Desmopressin daily for 2 months, then 60 microgram daily for 2 months, then 60 microgram every 2 days. The second group received 5 mg oxybutynin twice a day for 6 months. The patients were followed after 1, 3, and 6 months to track treatment response. The study outcomes were frequency of nocturnal enuresis, urinary incontinency, urgency, and frequency. Data were analyzed using SPSS software.ResultsThere were no significant differences between the two groups with respects to sex, age, place of residence, and parents’ education (p<0.05). Nocturnal enuresis, incontinency, urgency, and frequency of nocturnal enuresis was significantly lower with Desmopressin treatment in comparison to the oxybutynin treated group after 1 and 3 months (p<0.05). In addition, constipation and xerostomia were more frequent among the oxybutynin group after 1, 3, and 6 months (p<0.01). Blurred vision was also more frequent among oxybutynin group after 3 months (p<0.01). After 6 months the frequency of nocturnal enuresis and its frequency was higher in oxybutynin group in comparison to the Desmopressin group (p<0.05).ConclusionDesmopressin is more effective and has lower rate of side effects in comparison to oxybutynin for treatment of nocturnal enuresis. We recommend using Desmopressin for treatment of nocturnal enuresis in children. More studies are needed to achieve the best pharmacological treatment option for treatment of nocturnal enuresis.Trial registrationThe trial is registered at ClinicalTrials.gov with a ClinicalTrials.gov Identifier: NCT02538302FundingThe funder of this research is Hormozgan University of Medical Sciences.

Efficacy of posterior tibial nerve stimulation in the treatment of children with primary mono-symptomatic nocturnal enuresis

Background/Aims: Primary monosymptomatic nocturnal enuresis is the most frequent (85%) type of enuresis in children. However, there is limited research on the effect of posterior tibial nerve stimulation on monosymptomatic nocturnal enuresis in children. This study investigated the effect of posterior tibial nerve stimulation on primary monosymptomatic nocturnal enuresis in children. Methods: This controlled exposure study was conducted using a pretest–posttest design between March and December 2014. Participants (n=80) were randomly distributed to two study groups (control and intervention) using block randomisation. Participants in the control group were given and instructed on how to use a bedwetting alarm in addition to medical treatment for 12 weeks, whereas participants in the intervention group received posterior tibial nerve stimulation in addition to medical treatment for 12 weeks. The frequency of nocturnal enuresis, maximum voided volume and quality of life were evaluated before and after treatment. Results: Comparative analysis between pre- and post-treatment data revealed significant differences in both groups across all measured variables (p&lt;0.05), with significant improvements in all three outcome measures found in the intervention group. Post-treatment, the intervention group demonstrated decreased frequency of nocturnal enuresis and improved maximum voided volume and quality of life. Conclusions: Posterior tibial nerve stimulation is an effective and safe approach for the treatment of primary monosymptomatic nocturnal enuresis and control of bedwetting in children.

Can Frequency of Nocturnal Enuresis in Bladder Diary Predict the Efficacy of Urotherapy?

Can Frequency of Nocturnal Enuresis in Bladder Diary Predict the Efficacy of Urotherapy?

193 EFFECTS OF DESMOPRESSIN PLUS PROPIVERINE FOR THE TREATMENT OF MONOSYMPTOMATIC PRIMARY NOCTURNAL EENURESIS IN CHILDREN

INTRODUCTION AND OBJECTIVES: We evaluated the efficacy of a combination treatment of desmopressin and propiverine for treating children with monosymptomatic primary nocturnal enuresis. METHODS: A total of 53 children aged 6 to 15 years old with monosymptomatic nocturnal enuresis were enrolled in this prospective study. Children with a minimum of 3 wet nights weekly were included. Children were randomly assigned groups and treated with desmopressin 0.2mg, or a combination of desmopressin plus propiverine 10mg. Of these patients 43 (31 boys and 12 girls, mean age 8.4 2.5 years, range 4 to 13) were followed for more than 6 months. Efficacy was measured at 1, 3 and 6 months in terms of average enuretic frequency after treatment. RESULTS: Of the 43 children finally analyzed, 23 received combination therapy of desmopressin and propiverine and 20 received desmopressin alone. The frequency of nocturnal enuresis at baseline in the monotherapy group and combination therapy group was similar (5.45 1.57 vs 5.82 1.44). However, a decrease of the nocturnal enuresis was significantly pronounced in the combination group after 6 months treatment than in monotherpy group (2.2 1.01 vs 1.29 0.67). Combination therapy produced better outcomes than monotherapy in terms of the number of nocturnal enuresis episodes (p 0.017). Adverse events were minimal. CONCLUSIONS: Combination therapy with desmopressin plus propiverine for the treatment of monosymptomatic nocturnal enuresis was well tolerated, and gave effective results in reducing enuresis episodes rather than a single therapy of desmopressin in children.

Nocturnal Enuresis and its Treatment among Primary School Children in Calabar-Nigeria

Background: Enuresis for most children is a source of shame and anxiety with a profound effect on self perception, relationship and school performance. Hence the study of nocturnal enuresis among primary school children in Calabar- Nigeria. Aims and objectives: This was to determine the frequency of enuresis among primary school children in Calabar and to study the treatment modalities. Study design: This was a prospective cross sectional study. A questionnaire was answered by parents of 3,230 pupils from six selected schools during the school term between January 2010 to March 2010. Results: The frequency of nocturnal enuresis was 6.7%. Enuresis frequency was higher among boys (7.3%) than girls (6.0%) though this was not statistically significant (P=0.216). Treatment methods used were medication (1.6%), water restriction (42.8%), awaking for voiding (27.3%) use of alarm bell (0.5%), herbal medication (8.0%), while 19.8% received no form of treatment. Help – seeking behavior for this condition was poor as only 2.1% of this study population ever sought medical attention for this condition. Conclusion and recommendation: The frequency of enuresis was similar to most reports in literature. Help- seeking behavior was poor. Parental education, advocacy and awareness creation on the availability of medical help for enuresis are suggested.

Nocturnal Enuresis And Its Treatment Among Primary School Children In Calabar Nigeria.

Background: Enuresis for most children is a source of shame and anxiety with a profound ef fect on sel f percept ion, relationship and school performance. Hence the study of nocturnal enuresis among primary school children in Calabar-Nigeria. Objectives: This was to determine the frequency of enuresis among primary school children in Calabar and to study the treatment modalities. Patients and Methods: This was a prospective cross sectional study. A questionnaire was answered by parents of 3,230 pupils from six selected schools during the school term between January to March, 2010. Results: The frequency of nocturnal enuresis was 6.7%. Enuresis frequency was higher among boys (7.3%) than girls (6.0%) though this was not statistically significant (P=0.216). Treatment methods used were medication ( 1.6%) , water restriction (42.8%), awaking for voiding (27.3%) use of alarm bell (0.5%), herbal medication (8.0%), while 19.8% received no form of treatment. Help seeking behavior for this condition was poor as only 2.1% of this study population ever sought medical attention for this condition. Conclusion: The frequency of enuresis was similar to most reports in literature. Help-seeking behavior was poor. Parental education, advocacy and awareness creation on the availability of medical help for enuresis are suggested. Key words: Nocturnal enuresis, Treatment, School children.

Prevalence and risk factors of monosymptomatic nocturnal enuresis in Turkish children

ObjectivesTo determine the prevalence of primary monosymptomatic nocturnal enuresis (PMNE) and assess risk factors that can cause this disease.MethodsAfter the determination of 15 primary schools in the provincial center of Ankara, questionnaires were given to 15,150 students to be answered by their parents. Detailed urologic history was obtained and physical examination applied to the students whose parents answered the questionnaire. After excluding children with polysymptomatic NE, 14060 questionnaires of MNE patients were evaluated. Demographic features with social and medical history of students and their parents, general approach of family to the children, school success of the students and general behavioral attitudes, method of toilet training and the presence of nocturnal enuresis were questioned.ResultsMNE was determined in 9.0% (n: 1266) of the students and nocturnal enuresis frequency was higher in boys than girls (P<0.05). Univariate analysis revealed gender, method of toilet training, sleep problems, school success, and general approach of the family to children and general behavioral attitudes of the children as significant factors. In logistic regression analysis; age, male gender, toilette training with threatening method, deep sleeper, sleep walking, being introverted and shy, significantly increases the risk of nocturnal enuresis.ConclusionsThe current study suggests that the methods of toilet training are extremely important to prevent bedwetting and behavioral disorders due to enuresis. Parents should be well-informed about the appropriate toilet training method.

Asymptomatic bacteriuria in men with orthotopic ileal neobladders: possible relationship to nocturnal enuresis

To assess prospectively the incidence with time of asymptomatic bacteriuria in patients with orthotopic ileal neobladders, and the possible effect on neobladder function. In all, 47 patients (mean age 52.7 years, sd 8.7, range 31-68) with uncomplicated orthotopic ileal neobladders were prospectively evaluated. With no antibiotic manipulation, consecutive urine cultures were assessed monthly. Continence was assessed by direct information from the patients at each follow-up visit. Overall, 797 samples were cultured from the 47 patients (mean 17.6, sd 7.1). There was a steady decrease in the incidence of positive cultures, from 74.5%, to 35.6% and 6.7% at 1, 6 and 18 months, respectively. While there was persistently sterile urine in only eight patients (17%), 32 had occasional and seven had persistent bacteriuria. Escherichia coli was the commonest organism (76.6%) followed by Klebsiella pneumonia (15.7%); 54% of E. coli and 38% of K. pneumonia infections were sensitive to nitrofurantoin. Diurnal continence was achieved in 98% of the patients at 6 months after surgery. There was a gradual decrease in the frequency of nocturnal enuresis (NE) with time, from 87%, to 42%, 28% and 27% at 1, 6, 12 and 18 months, respectively. There was a significant correlation between the presence of bacteriuria and NE during the first 6 months, but it was not sustained after that. The age of the patients was also related significantly to the incidence of NE; at 6 months, only one of 18 men aged < or = 50 years had NE, while 19 of 29 aged > 50 years had (P < 0.001). At 1 year all patients aged < or = 50 years were nocturnally continent, while half of those aged > 50 years had NE (P = 0.001). Ileal neobladders are associated with a high incidence of asymptomatic bacteriuria during the first year after surgery. There was spontaneous clearance of bacteriuria with time, with no antimicrobial manipulation. Soon after surgery there was a significant association between bacteriuria and NE. The effect of antimicrobials on patients with NE should be evaluated.

Social Skills Training and Counselling in a Clinical Setting: Evaluation of a Schizophrenic Patient in a Psychiatric Hospital

Ongoing clinical counselling was provided for a schizophrenic patient during a 12-week programme of social skills training. Changes in the patient’s behaviour were evaluated on an Adult Training Instrument, his own reports of his symptoms of anxiety, scores on the Social Behaviour Schedule, and frequency of nocturnal enuresis. Supportive clinical counselling was provided in the ward and outside of the ward. While his functioning continued to deteriorate generally, hospital staff reported that the trend of deteriorating behaviour appeared to have slowed down during the phase when he was exposed to activities outside the ward.

Case Study of a Schizophrenic Patient during Social Skills Training in a Forensic Psychiatry Ward

A schizophrenic patient's behaviour was monitored over 12 weeks using the Assessment Schedule and Adult Training Instrument, the patient's self-reports of his symptoms of anxiety, scores on the Social Behaviour Schedule, and the frequency of nocturnal enuresis. Contrary to expectations, the patient's functioning deteriorated generally, with the exception that the trend of deteriorating behaviour, as assessed by hospital staff, appeared to have slowed down during a period involving activities out of the ward.