Non-monosymptomatic Nocturnal Enuresis Research Articles

Evaluation of the association between asthma and non-neurogenic urinary incontinence in children; a case-control study

BackgroundAsthma is the most common chronic disease in children. Asthma can lead to sleep disorders and psychiatric issues, which are often accompanied by urinary incontinence in children. Furthermore, several studies have shown a relationship between allergic diseases and urinary incontinence. This study aims to examine the association between asthma and non-neurogenic urinary incontinence.Materials and methodsThis case-control study included 314 children over three years old referred to Amir Kabir Hospital; 157 with asthma and 157 without asthma. After explaining each urinary disorder in accordace with the International Children’s Continence Society’s definitions, parents and children were asked about their presence. The disorders included monosymptomatic nocturnal enuresis(MNE), nonmonosymptomatic nocturnal enuresis (NMNE), vaginal reflux (VR), pollakiuria, infrequent voiding, giggle incontinence (GI), and overactive bladder (OAB). The analysis was performed using Stata 16.ResultsThe average age of the children was 8.19 ± 3.15 years. Patients with asthma (p = 0.0001) and GI (p = 0.027) had a considerably lower average age than patients without these disorders. Asthma and urinary incontinence, including NMNE, Infrequent voiding, and OAB, were significantly correlated (p = 0.017, 0.013, and 0.0001, respectively). Moreover, the association between MNE and asthma was significant in males (p = 0.047).ConclusionDue to the relationship between asthma and urinary incontinence, children with asthma must be evaluated for the presence of urinary disorders and, if present, receive the proper treatment in order to improve their quality of life.

The association between primary nonmonosymptomatic nocturnal enuresis and the presence of specific phobia: a case–control study

BackgroundNocturnal enuresis (NE) is a common childhood condition characterized by recurrent bedwetting in children with normal bladder control over 5 years old. The pathogenesis of this condition is unknown, but it is believed to have a complex etiology. NE is primary or secondary, monosymptomatic or nonmonosymptomatic (NMNE). MNE children do not have lower urinary tract (LUT) impairment, and their voided volumes are generally normal. NMNE is linked to malfunction of the LUT, with or without daytime incontinence. Several investigations have discovered significant associations between psychiatric problems, especially anxiety disorders and NMNE. Specific phobia is the most common lifelong anxiety disorder, characterized by extreme anxiety when a stimulus is encountered or expected. This study investigated the association between specific phobia and primary NMNE.MethodsA total of 204 children were studied, including 102 children with primary NMNE and 102 children in the control group. Girls with an FSS-II score greater than 75 and boys with a score greater than 78 were considered to have specific phobia disorder. The groups were compared using SPSS software version 23 and descriptive statistical methods.ResultsThe results of the recent study showed that the mean age of the children in the case and control groups was 7.69 and 7.19 years, respectively (p-value = 0.063). The male to female ratio was 49–53 in the case group and 43–59 in the control group (p-value = 0.399). In the study, the frequency of specific phobia in the case group was 12.7% and in the control group was 9.8% (p-value = 0.507).ConclusionsDespite the strong impacts of anxiety on children's NMNE, there is likely no significant association between specific phobia and primary NMNE.

The Desmopressin melt therapy in children with non-monosymptomatic nocturnal enuresis: a prospective study

Objective: The negative consequences of enuresis in children can be far reaching and an understanding of the impact of these is essential for effective treatment by the clinician. Enuresis can be categorized into monosymptomatic nocturnal enuresis (MNE) and non-monosymptomatic nocturnal enuresis (NMNE). There have been several studies in treatment of MNE with lyophilizate desmopressin melt but very limited research into the efficacy of desmopressin melt in treating NMME. The objectives of this study were to measure the efficacy and side effects of desmopressin melt in treating children with NMNE. Materials and Methods: Children aged 6 to 18 years with NMNE who visited the outpatient department of pediatric urology were included in this prospective study. Any underlying diseases and lower urinary tract symptoms were corrected then their enuresis was treated with 120-240 mcg of desmopressin melt for 6-8 weeks. Outcomes were defined as complete response, partial response, and no-response as defined by the International Children’s Continence Society guidelines. Results: A total of 25 children with NMNE were included in the study. The results showed 44% complete response, 20% partial response, and 36% no-response. The mean volume of nocturnal enuresis decreased from 159.96 to 115.30 ml in the pre and post treatment periods, respectively (p = 0.012). The mean frequency of enuresis decreased from 4.36 to 2.84 days per week in pre and post treatment periods, respectively (p < 0.001). The mean whole night urine volume decreased from 373.39 to 292.37 ml in pre and post treatment periods (p = 0.061). There were no major side effects in the study. Conclusion: Desmopressin melt is effective and safe in treating NMNE in children. However, to add weight to the findings of this study further research with a larger number of patients should be considered in the near future.

Prevalence, Risk Factors, and Psychological Effects of Primary Nocturnal Enuresis in Chinese Young Adults.

PurposeThis study aimed to investigate the prevalence, risk factors, and effects of primary nocturnal enuresis (PNE) on physical and mental health in young adults in mainland China.MethodsAn anonymous questionnaire was used to collect information including the sociodemographic characteristics, history of PNE, family history, daytime voiding symptoms, Pittsburgh Sleep Quality Index (PSQI) scores, Self-Esteem Scale (SES), and Self-Rating Depression Scale (SDS). A total of 22,500 university students from 23 provinces and 368 cities in mainland China were included.ResultsIn total, 21,082 questionnaires were collected, and 20,345 of them qualified for statistical analysis. The PNE prevalence was 1.17%, and the distribution of monosymptomatic nocturnal enuresis (MNE) and nonmonosymptomatic nocturnal enuresis (NMNE) was 66.1% and 33.9%, respectively. In total, 28% of respondents with PNE reported bedwetting daily, 31.6% between 1 and 7 times weekly, and 40.4% between 1 and 4 times monthly; 80% of PNE cases had no history of treatment. The prevalence of PNE in patients with a family history, frequency, urgency, urinary incontinence, and recurrent urinary tract infections was significantly higher than in those without these conditions (P<0.001). PNE was significantly correlated with the PSQI total score (sleep quality) (P=0.011). The SES score was lower and the SDS was higher (P<0.001) in the PNE group than in those without PNE.ConclusionsIn mainland China, the PNE prevalence among young adults was found to be high, and PNE had significant effects on physical and mental health. Risk factors included a family history, daytime voiding symptoms, and lack of treatment.

Efficacy and safety of multimodal treatment in nocturnal enuresis - A retrospective cohort study

Most treatments of nocturnal enuresis (NE) are targeting the main pathophysiological mechanisms, i.e., excess nocturnal urine production, bladder reservoir dysfunction and inability to awaken to a full bladder. Although many children can be effectively treated with only one treatment modality, there is a significant number of treatment-refractory cases. We experience an increasing tendency to combine treatment modalities in those children. However, there is limited evidence regarding the efficacy and safety of such strategies. We reviewed files from all NE children seen in our outpatient incontinence clinic between January 1st and December 31st 2017 and identified children refractory to first line treatment receiving a combination of at least two treatment modalities concurrently. Age, gender, wet nights per week before treatment, follow-up time, previous treatment with desmopressin or alarm, phenotype of NE, number of simultaneous treatments tried and response as well as registered side effects during treatment was noted. We registered the outcomes and safety of the treatment modalities and evaluated prognostic factors. We identified 59 children (13 girls) aged 6-15yrs (mean 9.6yrs) of whom 30 were monosymptomatic NE (MNE) and 29 were non-monosymptomatic NE (NMNE) patients. They all suffered at least three wet nights per week before treatment. In total, 38 children (61%) became dry on multimodal therapy. Eighteen children (30%) became dry on a combination of two treatment modalities, 16 (27%) on three modalities, and two (3%) on four modalities. Nine children (15%) achieved partial response whereas three (5%) showed no response despite multiple tries with combination therapies. A total of 18 children (30%) reported side effects to one or more of the modalities tried. Side effects that led to discontinuation of the treatment were uncommon (three patients). Treatment refractory NE represents a challenge for the clinician. Although it seems possible to adequately treat refractory NE patients with multimodal treatment one should be aware of side effects as well as inform the families of the challenges in the treatment of refractory enuresis patients. Future RCT's should focus on providing further evidence for the role of multimodal therapy in NE treatment.

Can the combined treatment of solifenacin and imipramine has a role in desmopressin refractory monosymptomatic nocturnal enuresis? A prospective double-blind randomized placebo-controlled study.

Nocturnal enuresis is a common disease of childhood. It can be classified into monosymptomatic nocturnal enuresis (MNE) or nonmonosymptomatic nocturnal enuresis (NMNE). Imipramine is a tricyclic antidepressant used to treat enuresis with initial success rates are high as 50% but some studies record a high relapse rate and it has a cardiotoxic effect when overdosed. Anticholinergics may be effective in the treatment of children with bladder storage dysfunction, including daytime incontinence. However, anticholinergics monotherapy is not effective in treating MNE. In our study, we used a low dose (25 mg) of imipramine in order to avoid its potential side effects and combined it with the synergistic anticholinergic action of solifenacin. Our objective was to evaluate the efficacy and safety of the combination of solifenacin and imipramine compared with placebo in the treatment of desmopressin refractory MNE. One hundred children aged 6 years or more with primary MNE unresponsive to desmopressin treatment were included. The children were randomly divided into two equal groups. Group A received imipramine 25 mg and solifenacin 5-10 mg oral tablets and group B received placebo once 1 h before bedtime for 3 months. The primary end point was to investigate the efficacy of the combined treatment of solifenacin and imipramine and the secondary end point was the safety of the drugs. Our study showed that the mean post treatment wet nights per month was significantly lesser in the treatment group than placebo group (p < 0.001) and cure rate was significantly higher in treatment group than placebo group (p < 0.001). The relapse rate was statistically significantly lower in treatment group than placebo group (p = 0.032). No significant side effects related to the drugs were reported. The combination treatment of solifenacin and imipramine is a useful and safe treatment for nocturnal enuresis after failure of everything else.

Evaluation of Functional Bladder Capacity in Children with Nocturnal Enuresis According to Type and Treatment Outcome.

PurposeThis study aimed to identify whether functional bladder capacity (FBC) differs among subgroups of nocturnal enuresis (NE) patients and can be used to predict treatment response.MethodsA total of 69 children with NE were included in this study between July 2017 and February 2019 according to medical chart review, retrospectively. All patients completed a questionnaire about voiding symptoms and 48-hour frequency/volume (48-h F/V) charts. FBC was obtained from the 48-h F/V charts and uroflowmetry (UFM) with post-void residual volume (PVR). All patients were primarily treated with standard urotherapy and pharmacological therapy. The response rate was analyzed at 3 months after treatment.ResultsThe mean age of the 69 patients (42 male, 27 female) was 83.3 ± 22.4 months (range, 5–13 years) at the first visit. The percentages of children with monosymptomatic NE (MNE) and non-monosymptomatic NE (NMNE) on the questionnaire were 40.6% (28/69) and 59.4% (41/69), respectively. FBC of all patients was lower than the normal range of expected bladder capacity, and there were no significant differences between measurement methods, NE types (MNE vs NMNE), or response rates (p > 0.05).ConclusionChildren with NE had diminished FBC in both 48-h F/V charts and UFM with PVR. We found no difference in FBC by NE type or treatment outcome. Therefore, FBC cannot be used to distinguish between NE types or predict treatment responses.

Behavioral comorbidity, overweight, and obesity in children with incontinence: An analysis of 1638 cases.

Children with nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI) are at risk for behavioral problems, overweight, and obesity. The aim of this study was to analyze the specific behavioral and weight comorbidity in subtypes of incontinence. A total of 1638 consecutive patients presented to a tertiary incontinence clinic from 2012 to 2018 was examined prospectively according to ICCS criteria. Behavioral symptoms were measured with the Child Behavior Checklist (CBCL). Psychiatric disorders were diagnosed according to ICD-10 criteria. Weight categories were calculated according to WHO recommendations. The mean age was 7.8 years, 67% of patients were male. Fifty-seven percent had NE (n = 934), 33% DUI (n = 547), and 40% FI (n = 656). Boys had significantly higher rates of NE and FI than girls. Of all children, 39.2% (n = 539) had a clinically relevant CBCL total score. A total of 28.3% (n = 463) had an ICD-10 psychiatric diagnosis, mainly ODD and ADHD, and 28.6% (n = 463) were overweight or obese. Boys were more often affected by behavioral symptoms, psychiatric disorders, and overweight/obesity. Children with NE had the highest rate of overweight/obesity. Except for primary nonmonosymptomatic NE, subtypes of incontinence did not differ regarding behavioral symptoms and weight categories. However, overweight/obesity was significantly associated with behavioral and psychiatric parameters. Behavioral symptoms and psychiatric disorders, as well as overweight/obesity are important risk factors associated with incontinence, but the interaction between these factors is complex. In clinical settings, all children with incontinence should be screened with behavioral questionnaires. Also, weight should be measured, and overweight/obesity should be addressed.

Clinical profile and risk factors of enuresis in children

Background: Enuresis is a common problem in children and its incidence is multifactorial in nature. The aim of this study is to assess the etiological risk-factors in enuresis in the study population and also to compare the risk factors in enuresis subgroups.Methods: A total of 51 patients with enuresis presenting to the department of paediatrics, Institute of Social Paediatrics, Govt. Stanley Hospital, Chennai were included in the study. All children were sub classified as primary/secondary and the primary enuretics were sub classified into monosymptomatic/non monosymptomatic depending on the symptoms. The data was analyzed and the results presented.Results: Enuresis was common in boys. Statistically significant difference in the incidence of disorder between primary and secondary enuretic children was seen in relation to presence of storage symptoms (p=0.04), cystitis (p=0.013) sleep disordered breathing (p=0.0001) and low-income status (p=0.04). No statistically significant difference between into monosymptomatic nocturnal enuresis (MNE) and non-monosymptomatic nocturnal enuresis (NMNE) children was observed in terms of gender, difficulty in arousal, specific gravity, spina bifida, low bladder capacity and family history (p&gt;0.05).Conclusions: The findings of the study reported that risk factors related to the incidence is similar in both primary and secondary enuresis. MNE and NMNE have no differences in the presentation and probably represent the spectrum of a same disorder.

Re: Assessment of Serum Levels of Copeptin and Corticotropin-Releasing Factor in Children with Monosymptomatic and Non-Monosymptomatic Nocturnal Enuresis.

No AccessJournal of UrologyUrological Survey1 May 2020Re: Assessment of Serum Levels of Copeptin and Corticotropin-Releasing Factor in Children with Monosymptomatic and Non-Monosymptomatic Nocturnal Enuresis Douglas A. CanningMD Douglas A. CanningDouglas A. Canning More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000771.05AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Re: Assessment of Serum Levels of Copeptin and Corticotropin-Releasing Factor in Children with Monosymptomatic and Non-Monosymptomatic Nocturnal Enuresis." The Journal of Urology, 203(5), p. 870 © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue 5May 2020Page: 870-870 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Douglas A. Canning More articles by this author Expand All Advertisement PDF DownloadLoading ...

Nocturia in mothers and enuresis in children: Possible links.

The aim of the present study was to examine the relationship between nocturnal enuresis (NE) of childhood and nocturia of parents. The study was conducted across the network of general pediatricians of the ASL NA 1 of Naples, Italy. All the children with NE and their mothers were invited to attend the clinic for the study. Data were collected by personal interview. A 5-day bladder diary was collected from all the children. The mothers with nocturia were given a 3-day frequency-volume chart to assess the presence of nocturnal polyuria or reduced bladder capacity. Both children and mothers underwent a bladder ultrasound scan to measure the bladder wall thickness. A total of 224 mothers (aged between 23 and 45 years, average 33.3±4.1 years) and their 225 children (aged between 7 and 13 years, average 8.35±1.81 years) were investigated. Of the 224 mothers, 90 (40%) had nocturia, of which 55 (61%) clearly remembered that they had suffered from NE in childhood. Only 4 (11%) out of the 35 women without nocturia had NE (p<0.001). Children with persistence of NE beyond 11 years were more likely to have a parent with nocturia. Children with non-monosymptomatic NE were more likely to have mothers with nocturia (odds ratio (OR) 1.7, 95% confidence interval (CI) 1.2-7.1, p<0.01) or overactive bladder symptoms (OR 1.9, 95% CI 1.1-15.2, p<0.01). These data suggest that there is a link between NE in childhood and nocturia in adulthood. A strong relationship was found between overactive bladder in children and overactive bladder in their mothers.

Uroflowmetry in Non-Monosymptomatic Nocturnal Enuresis in Children of Coastal Region of Croatia.

The aim of the study was to describe clinical characteristics and bladder assessment in children with Non-Monosymptomatic Nocturnal Enuresis (NMNE) in coastal region of Croatia. Records on 85 patients with NMNE were retrospectively reviewed. Bladder assessments were performed in all children. In this research we: (i) compare clinical characteristics and features of bladder assessment: uroflowmetry, post void residuals (PVR) and bladder wall thickness between boys and girls with NMNE and we compare (ii) clinical characteristics and bladder assessment between children with primary and secondary NMNE. There were 46 girls and 39 boys. The total of 59 children had primary NMNE and 26 children had secondary NMNE. Uroflow pattern was abnormal in 42% of all children with NMNE. Abnormal uroflow pattern in children with NMNE was more often in girls than in boys (P < 0.05) and in children with secondary than in children with primary NMNE (P < 0.05). Ultrasound evidence of bladder wall thickness was more frequent in boys than in girls. Girls were more likely to have dysfunctional voiding and larger residual urinary volume than boys. Abnormal uroflow pattern in children with NMNE was more often in girls than boys and in children with secondary than in children with primary NMNE.

Experience Of Medical Treatment With Desmopressin And Imipramine In Children With Severe Primary Nocturnal Enuresis In Taiwan.

PurposeThe aim of this study was to compare the efficacy and safety of desmopressin and imipramine in the treatment of severe primary nocturnal enuresis (NE) in Taiwan.Patients and methodsThis study was a retrospective chart review study conducted on children with primary monosymptomatic nocturnal enuresis (PMNE) or non-monosymptomatic nocturnal enuresis (PNMNE), referred to and treated by senior physicians in a Changhua medical center in Taiwan. After being screened, these children were treated with either desmopressin (n = 125) or imipramine (n = 71). All participants were treated for at least 3 months and followed afterward for at least 3 more months. The response and relapse rates were measured. Side effects were monitored. Age, gender, and severity of NE were recorded.ResultsAfter 3 months of treatment, 97 children treated with desmopressin were responsive (77.6%) while 58 children treated with imipramine were responsive (81.7%). Sixty-one children treated with desmopressin (48.8%) and 26 treated with imipramine (36.6%) relapsed during the 3-month post-treatment monitoring. The differences in responsive and relapse rates were not statistically significant. Four children treated with imipramine (5.6%) reported side effects while none was reported for children treated with desmopressin (P < 0.05). Age, gender, and the presence or absence of daytime enuresis did not influence the response rate to either drug (P < 0.05).ConclusionCurrently, desmopressin is preferred over imipramine for treating NE due to the latter’s side effects. Our results demonstrated similar response rates for both drugs, with imipramine demonstrating minimal side effects. While health practitioners should pay attention to its side effects, concerns regarding imipramine toxicity in NE treatment are often overblown. Since imipramine is much cheaper than desmopressin, using imipramine to manage NE can allow health practitioners, especially in Taiwan, to treat the greatest number of children with NE.

Letter to: Assessment of Blood Pressure in Primary Non-Monosymptomatic Nocturnal Enuresis

Letter to: Assessment of Blood Pressure in Primary Non-Monosymptomatic Nocturnal Enuresis

Innocent heart murmurs and enuresis: Examining a possible link.

The aim of this study was to evaluate the prevalence of innocent heart murmurs in children affected by nocturnal enuresis (NE). The prevalence of innocent heart murmurs in G2 was 6.34%. This condition was significantly more frequent in children who suffered from NE. Indeed, in G1, the prevalence of innocent heart murmurs was 21.45%, although there were few differences between the children with monosymptomatic NE and non-monosymptomatic NE; moreover, this prevalence was higher in males. We enrolled a total of 401 children (G1), 300 males and 101 females, aged 5-15 years, affected by NE and referred to the Service of Pediatrics, "Campus Bio-Medico" University Hospital of Rome, from September 2013 to September 2018, into the study. The control group was composed of 394 children without NE (G2). The study was carried out in compliance with the Helsinki Declaration. These findings made us aware of the presence of possible underlying mechanisms, which explain the association between a higher prevalence of innocent heart murmurs and enuresis, and further studies are required to explore this issue.

Pelvic floor muscle training alone or in combination with oxybutynin in treatment of nonmonosymptomatic enuresis. A randomized controlled trial with 2-year follow up.

Objective To compare the results of the standard urotherapy alone and associated with pelvic floor muscle training alone, and in combination with oxybutynin in treatment of nonmonosymptomatic nocturnal enuresis.Methods A total of 38 children aged 5 to 10 years were randomized into three groups: Group I (n=12) that was submitted to standard urotherapy; Group II (n=15), standard urotherapy associated with pelvic floor muscle training; and Group III (n=11), standard urotherapy associated with pelvic floor muscle training and oxybutynin; the treatment lasted 12 weeks. The assessment tools used were playful bladder diary, and a 48-hour bladder diary, before and after treatment. After 2 years, patients were assessed by telephone using a standardized questionnaire.Results The data of children from the three groups were homogeneous at baseline. After 12-week treatment, all children showed improved symptoms and signs of nonmonosymptomatic nocturnal enuresis, but the differences were not significant among the groups. After 2 years, the three groups showed maintenance of treatment results, but no differences among them.Conclusion All treatment modalities were effective regarding improved enuresis and lower urinary tract symptoms, but the sample was not large enough to show differences among groups.

Assessment of serum levels of copeptin and corticotropin-releasing factor in children with monosymptomatic and non-monosymptomatic nocturnal enuresis

Nocturnal enuresis is defined as bed-wetting in children from the age of five years that occurs during sleep; if untreated, the condition can result in social and psychological problems both for the children and their parents. Nocturnal enuresis is a complicated disease that includes multiple pathogenetic factors. Nocturnal enuresis is divided into two subgroups: monosymptomatic and non-monosymptomatic. The role of some biomarkers in patients with monosymptomatic enuresis has been reported in a small number of the studies. The aim of this research was to evaluate the serum levels of copeptin and corticotropin-releasing factor (CRF) in monosymptomatic and non-monosymptomatic nocturnal enuresis cases. Although these markers were previously examined in children with monosymptomatic enuresis, there is no study that has evaluated these markers in non-monosymptomatic children. One hundred nineteen children with nocturnal enuresis (5-16 years) and forty healthy children (5-17 years) were enrolled to the study. Of the nocturnal enuresis group, forty-nine were monosymptomatic and seventy were non-monosymptomatic. Copeptin and CRF were measured by a competitive inhibition method with enzyme-linked immunosorbent assay. The serum copeptin levels were significantly lower in children with monosymptomatic and non-monosymptomatic nocturnal enuresis than in the controls.(median, 34.7 [interquartile range (IQR): 34pg/ml], 39.8 [IQR: 29pg/ml] vs52.1 [IQR: 14pg/ml], respectively, P<0.05). The serum CRF levels were significantly lower in children with monosymptomatic and non-monosymptomatic nocturnal enuresis than in the controls (median, 35.1 [IQR: 19pg/ml], 34.05 [IQR: 24pg/ml] vs78.3 [IQR: 39pg/ml], respectively, P<0.05). There was no significant difference in copeptin and CRF levels between the children with monosymptomatic and non-monosymptomatic nocturnal enuresis. Copeptin is presumed to be a sensitive surrogate biomarker for arginine vasopressin release. To date, there are only two studies in the literature that assess the relationship between copeptin and monosymptomatic enuresis. The only study in the literature demonstrated significantly decreased levels of CRF in monosymptomatic enuretic children. It was demonstrated that the levels of copeptin and CRF differ in both children with monosymptomatic and non-monosymptomatic nocturnal enuresis from the control groups. It was also demonstrated that copeptin and CRF levels were not different between the children in monosymptomatic and non-monosymptomatic groups. Those changes in both copeptin and CRF which were shown in this study in monosymptomatic and non-monosymptomatic enuretic children may contribute to the pathogenesis of nocturnal enuresis. Further case-control studies can evaluate the copeptin and CRF levels before treatments in monosymptomatic and non-monosymptomatic patients to decide potential effectiveness of treatment.

The role of copeptin and corticotropin-releasing factor in children with monosymptomatic and nonmonosymptomatic nocturnal enuresis

The role of copeptin and corticotropin-releasing factor in children with monosymptomatic and nonmonosymptomatic nocturnal enuresis

The Relationship Between Nocturnal Enuresis and Spina Bifida Occulta: A Prospective Controlled Trial

ObjectiveTo compare the frequency of spina bifida occulta (SBO) detected in patients with nocturnal enuresis (NE) and to investigate its clinical significance. MethodsPatients aged 6 to 15 years who were admitted to the urology clinic with NE were included in this prospective study. The control group consisted of patients who were admitted with a complaint of abdominal or lateral pain. The patients who had lower urinary tract symptoms (LUTS) were classified as nonmonosymptomatic NE (NMNE). Those with monosymptomatic NE were treated with desmopressine. In patients with NMNE, treatment with oxybutynin was added if an overactive bladder or uninhibited contraction was detected by urodynamics. ResultsA total of 184 NE and 180 control patients were included in the study. SBO was detected in 71 (19.5%) patients and LUTS in 100 (27.4%). When the groups with and without NE were compared, the number of patients with SBO (26% vs 17%, P = .044) and those with LUTS (36% vs 17.5%, P < .001) were significantly higher in the NE group. The overall rate of dryness (67.4% vs 83.6%, P = .024) and response to LUTS treatment (65% vs 97%, P < .01) were significantly lower in those with SBO than in those without SBO. ConclusionSBO is more common in NE patients than in non-NE patients. Response to NE treatment is lower in SBO patients with severe LUTS; for this population, advanced treatment options may be considered earlier.

Assessment of Blood Pressure in Primary Non-Monosymptomatic Nocturnal Enuresis

Background: Enuresis has been defined as bed voiding at least twice a week for more than 3 consecutive months in individuals older than 5 years of age. Increased nocturnal enuresis could be possibly associated with dysfunction of autonomic nervous system. To observe autonomic nervous system function in enuretic children, the current study performed management of blood pressure. Methods: In this study, primary non-monosymptomatic nocturnal enuresis and healthy children were enrolled and blood pressure was measured twice, in the morning and afternoon. Urinalysis, urine culture, and urinary system ultrasound were carried out for the patients. A diary on the daily fluid intake and volume of daily urine was required. Results: The researchers observed that there was a significant difference between age variation (P value = 0.001) gender variation (P value = 0.030), educational level of patients’ mothers and fathers (P value = 0.001) and record of hypertension in the family (P value = 0.001) between case and control groups. Conclusions: In children affected by primary non-monosymptomatic nocturnal enuresis, nighttime Systolic Blood Pressure (SBP) were significantly higher, than healthy children. These circadian blood pressure provisions may reflect pathogenesis of primary non-monosymptomatic nocturnal enuresis and autonomic nervous system dysfunction.