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Creative Nursing Feb 2020Bedwetting, also called nocturnal enuresis, is a common developmental problem in school-aged children. In a study by Van Tijen, Messer, & Namdar (1998), children ranked...
Bedwetting, also called nocturnal enuresis, is a common developmental problem in school-aged children. In a study by Van Tijen, Messer, & Namdar (1998), children ranked it as the third most stressful life event, after parental fighting and divorce. About 15% of affected children outgrow bedwetting on their own each year without medical intervention (Kiddoo, 2015), but inadequate knowledge and lack of support and guidance from family may lead to low self-esteem and mental distress in children dealing with this situation. Nonpharmacologic interventions like bedwetting alarms have a higher success rate (75%) and lower relapse rate (41%) than pharmacologic interventions (Monda & Husmann, 1995). This article discusses nonpharmacologic interventions for nocturnal enuresis: bedwetting alarms, motivational therapy, dietary modification, behavioral modification, and pelvic floor muscle training.
Topics: Adolescent; Behavior Therapy; Child; Child, Preschool; Female; Humans; Male; Nocturnal Enuresis; Self Concept
PubMed: 32024734
DOI: 10.1891/1078-4535.26.1.23 -
Neurourology and Urodynamics Feb 2020The objective of this update of the EAU-ESPU guidelines recommendations for nocturnal enuresis was to review the recent published literature of studies, reviews,... (Review)
Review
BACKGROUND AND AIMS
The objective of this update of the EAU-ESPU guidelines recommendations for nocturnal enuresis was to review the recent published literature of studies, reviews, guidelines regarding the etiology, diagnosis and treatment options of nocturnal enuresis and transform the information into a practical recommendation strategy for the general practitioner, pediatrician, pediatric urologist and urologist.
MATERIAL AND METHODS
Since 2012 a monthly literature search using Scopus® was performed and the relevant literature was reviewed and prospectively registered on the European Urology bedwetting enuresis resource center (http://bedwetting.europeanurology.com/). In addition, guideline papers and statements of the European Society for Paediatric Urology (ESPU), the European Association of Urology (EAU), the National Institute for Health and Care Excellence (NICE) and the International Children Continence Society (ICCS) were used to update the knowledge and evidence resulting in this practical recommendation strategy. Recommendations have been discussed and agreed within the working group of the EAU-ESPU guidelines committee members.
RESULTS
The recommendations focus to place the child and his family in a control position. Pragmatic analysis is made of the bedwetting problem by collecting voiding and drinking habits during the day, measuring nighttime urine production and identification of possible risk factors such as high-volume evening drinking, nighttime overactive bladder, behavioral or psychological problems or sleep disordered breathing. A questionnaire will help to identify those risk factors.
CONCLUSION
Motivation of the child is important for success. Continuous involvement of the child and the family in the treatment will improve treatment compliance, success and patient satisfaction.
Topics: Child; Enuresis; Female; Guidelines as Topic; Humans; Male; Nocturnal Enuresis
PubMed: 31793066
DOI: 10.1002/nau.24239 -
Hong Kong Medical Journal = Xianggang... Aug 2019Enuresis is a common complaint in children, with a prevalence of around 15% at age 6 years. Evidence suggests that enuresis could affect neuropsychiatric development.... (Review)
Review
Enuresis is a common complaint in children, with a prevalence of around 15% at age 6 years. Evidence suggests that enuresis could affect neuropsychiatric development. The condition may represent an entire spectrum of underlying urological conditions. It is important to understand the difference between monosymptomatic and non-monosymptomatic enuresis. Primary monosymptomatic enuresis can be managed efficaciously with care in different settings, like primary care, specialist nursing, or paediatric specialists, while non-monosymptomatic enuresis requires more complex evaluation and treatment. The diagnosis, investigation, and management of the two types of enuresis are discussed in this review.
Topics: Antidiuretic Agents; Behavior Therapy; Child; Child, Preschool; Deamino Arginine Vasopressin; Humans; Nocturnal Enuresis; Physical Examination
PubMed: 31395789
DOI: 10.12809/hkmj197916 -
Heart Rhythm May 2022
Topics: Female; Heart; Humans; Male; Nocturnal Enuresis
PubMed: 35501108
DOI: 10.1016/j.hrthm.2022.01.031 -
Journal of Pediatric Urology Feb 2020Enuresis is an extremely common condition, which, although somatically benign, poses long-term psychosocial risks if untreated. There are still many misconceptions... (Review)
Review
BACKGROUND
Enuresis is an extremely common condition, which, although somatically benign, poses long-term psychosocial risks if untreated. There are still many misconceptions regarding the proper management of these children.
AIM
A cross-professional team of experts affiliated with the International Children's Continence Society (ICCS) undertook to update the previous guidelines for the evaluation and treatment of children with enuresis.
METHODS
The document used the globally accepted ICCS terminology. Evidence-based literature served as the basis, but in areas lacking in primary evidence, expert consensus was used. Before submission, a full draft was made available to all ICCS members for additional comments.
RESULTS
The enuretic child does, in the absence of certain warning signs (i.e., voiding difficulties, excessive thirst), not need blood tests, radiology or urodynamic assessment. Active therapy is recommended from the age of 6 years. The most important comorbid conditions to take into account are psychiatric disorders, constipation, urinary tract infections and snoring or sleep apneas. Constipation and daytime incontinence, if present, should be treated. In nonmonosymptomatic enuresis, it is recommended that basic advice regarding voiding and drinking habits be provided. In monosymptomatic enuresis, or if the above strategy did not make the child dry, the first-line treatment modalities are desmopressin or the enuresis alarm. If both these therapies fail alone or in combination, anticholinergic treatment is a possible next step. If the child is unresponsive to initial therapy, antidepressant treatment may be considered by the expert. Children with concomitant sleep disordered breathing may become dry if the airway obstruction is removed.
Topics: Child; Humans; Nocturnal Enuresis
PubMed: 32278657
DOI: 10.1016/j.jpurol.2019.12.020 -
Deutsches Arzteblatt International Apr 2019Elimination disorders in childhood are common and treatable. Approximately 10% of 7-year-olds wet the bed at night, and 6% are affected by incontinence during the... (Review)
Review
BACKGROUND
Elimination disorders in childhood are common and treatable. Approximately 10% of 7-year-olds wet the bed at night, and 6% are affected by incontinence during the daytime. Two main types of disturbance are distinguished: nocturnal enuresis and functional (i.e., non-organic) daytime urinary incontinence. Each type contains a wide variety of subtypes. Effective treatment requires precise identification of the subtype of elimination disorder.
METHODS
This review is based on a selection of current publications, including principally the German S2k-AWMF guideline and the recommendations of the International Children's Continence Society (ICCS).
RESULTS
Diagnostic assessment focuses on the clinical picture, is non-invasive, and can be carried out in most health care settings. If the child is suffering from multiple types of elimination disorder at once, then fecal incontinence or constipation is treated first, daytime urinary incontinence next, and enuresis last. 20-50% of children with elimination disorders have a comorbid mental disorder that also needs to be treated. With standard urotherapy, 56% of patients with daytime urinary incontinence become dry within a year. This conservative, symptom-oriented approach consists of educating the patient and his or her parents to promote behavior changes with respect to drinking and micturition. Elements of specific urotherapy are provided only if indicated. For enuresis, the treatment of first choice is alarm therapy, with which 50-70% of the affected children become dry. Pharmacotherapy, e.g., with desmopressin, can be a helpful adjunctive treatment. In intractable cases, training techniques have been found useful.
CONCLUSION
Childhood elimination disorders can be treated effectively after targeted diagnostic evaluation and the establishment of specific indications for treatment. In view of the emotional distress these disorders cause, the associated physical and mental disturbances, and their potential persistence into adolescence, they should be evaluated and treated in affected children from the age of five years onward.
Topics: Adolescent; Child; Diurnal Enuresis; Female; Humans; Nocturnal Enuresis; Treatment Outcome
PubMed: 31159915
DOI: 10.3238/arztebl.2019.0279 -
Journal of Pediatric Urology Oct 2021Enuresis is frequent in school-aged children and results from a complex interaction between genetics, biological and psychosocial factors. This study aims to analyze...
INTRODUCTION
Enuresis is frequent in school-aged children and results from a complex interaction between genetics, biological and psychosocial factors. This study aims to analyze bedwetting trajectories between 4 and 7 years of age and to evaluate the impact of biological and developmental characteristics of the child and sociodemographic factors in those bedwetting trajectories.
METHODS
Data from 5433 children from the Generation XXI population-based birth cohort was analyzed. Four bedwetting trajectories were defined: normative (acquired nighttime bladder control at 4 years and no enuresis at 7 years); delayed (no nighttime bladder control at 4 years and no enuresis at 7 years); enuresis (no nighttime bladder control at 4 years and enuresis at 7 years); and secondary enuresis (acquired nighttime bladder control at 4 years and enuresis at 7 years). Multinomial logistic regression models were fitted to test the association between biological and developmental characteristics of the child and sociodemographic factors with bedwetting trajectories.
RESULTS
At the age of 4 years, 36.5% of children had bedwetting (8.1% infrequently and 28.4% frequently) and at the age of 7 years, 11.0% had enuresis (5.8% infrequently and 5.2% frequently). Of the 4-year-old children who were infrequent bedwetters, 14.0% had enuresis at 7 years, while among frequent bedwetters, 30.2% had enuresis at 7 years. Regarding bedwetting trajectories, 26.8% of children were classified in the delayed trajectory, 9.7% in the enuresis trajectory and 1.3% were in the secondary enuresis trajectory. Children with developmental disorders presented an increased risk of being in enuresis trajectory (OR = 1.47, 95% CI 1.15-1.88) than children without developmental disorders. Living in overcrowded houses (OR = 1.60, 95% CI 1.12-2.30), growing up in families with low household income (OR = 1.27, 95% CI 1.03-1.57) and an orphan of one parent (OR = 3.19, 95% CI 1.18-8.64) presented higher odds of being in the enuresis trajectory than in the normative trajectory. Having a sibling both before the age of 4 years and between the ages of 4 and 7 years was associated with delayed trajectory (OR = 1.55, 95% CI 1.16-2.07) and with enuresis (OR = 1.53, 95% CI 1.01-2.33), when compared with children without siblings born at that time.
CONCLUSION
Both developmental disorders and sociodemographic factors seem to be important determinants of bedwetting trajectories. Further studies are needed to better characterize the impact of biological and environmental determinants, on the nighttime bladder control acquisition, to enable timely medical interventions that improve the quality of life of enuretic children.
Topics: Child; Child, Preschool; Cohort Studies; Enuresis; Humans; Nocturnal Enuresis; Parents; Quality of Life; Urinary Incontinence
PubMed: 34736725
DOI: 10.1016/j.jpurol.2021.07.031 -
Journal of Paediatrics and Child Health Aug 2021Bedwetting is a common paediatric condition. #Bedwetting has been established as the official hashtag to structure Twitter discussions about the condition. We analysed...
AIM
Bedwetting is a common paediatric condition. #Bedwetting has been established as the official hashtag to structure Twitter discussions about the condition. We analysed online Twitter discussions for #Bedwetting.
METHODS
Symplur, a Twitter analytics service was employed to aggregate Twitter activity, users and content including #Bedwetting, between October 2013 and November 2018. Activity was analysed via tweet volume and user adoption. Users were assorted using geographic location, occupation and affiliation data. Content in #Bedwetting Tweets was undertaken by retrieving information about retweets, links, frequently used words and hashtags.
RESULTS
A total of 101 412 tweets and 9957 users utilising #Bedwetting were identified. Most tweets were sent with links (93%). The average ± SD number of tweets using #Bedwetting per month increased from 96 ± 87 in 2013 to 2935 ± 1644 in 2015. Tweet volume decreased to 1960 ± 257 in 2016 and subsequently increased to 2901 ± 1110 in 2017. New users increased from 4 in 2013 to 9957 users in 2018. Users tweeted from 69 countries. Advocacy organisations comprised 35% of the top 100 influencers. Common words in #Bedwetting tweets were 'potty', 'best' and 'training'. Popular associated hashtags were #Pottytraining, #Solutions and #Moms. Hyperlinks in #Bedwetting tweets included advocacy, academic and commercial websites.
CONCLUSIONS
Our analysis of #Bedwetting highlights that Twitter is frequently used to discuss the condition's diagnosis and management. Various stakeholders in health care are utilising the platform to build awareness about bedwetting. We identified that Twitter is being employed to drive web traffic to other internet websites.
Topics: Child; Humans; Nocturnal Enuresis; Social Media
PubMed: 34008264
DOI: 10.1111/jpc.15428 -
Nursing Times Jul 1962
Topics: Child; Enuresis; Humans; Infant; Nocturnal Enuresis
PubMed: 14468001
DOI: No ID Found -
Primary Care Jun 2019Nocturnal enuresis is a common problem that children may present with in a primary care setting. It is important to take a detailed history to rule out secondary causes;... (Review)
Review
Nocturnal enuresis is a common problem that children may present with in a primary care setting. It is important to take a detailed history to rule out secondary causes; however, most cases are primary in nature. It is essential to demystify the problem and reassure parents by educating them that the episodes are nonvolitional and most children outgrow the problem over time. Behavioral interventions are considered first line and are most successful when the child is invested in succeeding. Interventions should be initiated with specific goals in mind. Medications are effective and should be used in conjunction with behavioral interventions.
Topics: Antidiuretic Agents; Behavior Therapy; Child; Clinical Alarms; Deamino Arginine Vasopressin; Female; Humans; Male; Nocturnal Enuresis
PubMed: 31030825
DOI: 10.1016/j.pop.2019.02.005