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The Angle Orthodontist Sep 2021To evaluate the influence of rapid maxillary expansion (RME) on nocturnal enuresis (NE) in children to discuss whether RME can be indicated as an alternative treatment... (Review)
Review
OBJECTIVES
To evaluate the influence of rapid maxillary expansion (RME) on nocturnal enuresis (NE) in children to discuss whether RME can be indicated as an alternative treatment for NE in those patients.
MATERIALS AND METHODS
An electronic search was performed in the following databases: PubMed/MEDLINE, Cochrane Library, Scopus, Science Direct, Google Scholar and LILACS. The literature review was blindly performed by two reviewers. References of each selected study were manually searched to identify articles that were not found by the electronic search. Kappa statistics were used to analyze interexaminer agreement after the selection of the articles. After reading the selected full-text articles, the studies that met the inclusion criteria were assessed qualitatively using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) and the Revised Cochrane risk-of-bias tool for randomized controlled trials-2 (RoB 2). The certainty level of evidence was assessed through the Grading of Recommendations, Assessment, Development and Evaluation tool. Kappa tests were used to analyze the interexaminer concordance level after the quality assessment of the studies.
RESULTS
A total of 488 articles were found; however, after applying the inclusion and exclusion criteria, only 8 studies were selected for the systematic review. A low certainty level of evidence suggested that RME seems to promote a variable reduction in frequency or a remission of NE in children in both the short (4, 6, and 8 months) and long term (13, 36, 48, and 120 months).
CONCLUSIONS
Based on currently available information, RME seems to promote an improvement in NE in children. However, the low quality of the existing evidence weakens the recommendation.
Topics: Child; Humans; Nocturnal Enuresis; Palatal Expansion Technique
PubMed: 33978712
DOI: 10.2319/042520-355.1 -
Medical Acupuncture Aug 2022Nocturnal enuresis (NE), often known as bedwetting, is a common condition in children and, as a result, they may have subsequent social impairments. The aim of this... (Review)
Review
INTRODUCTION
Nocturnal enuresis (NE), often known as bedwetting, is a common condition in children and, as a result, they may have subsequent social impairments. The aim of this study was to evaluate the efficacy of low-level laser therapy (LLLT) in children with NE.
METHODS
International databases with laser- and NE-related keywords were searched, and only randomized controlled trials (RCTs) that used any type of LLLT to treat NE and compared it with any type of control intervention were included. Eleven studies using laser acupuncture therapy (LAT), involving 927 participants, were included for a systematic review. A meta-analysis was conducted using full and partial response-rate variables. The analysis was performed using referred eporting tems for ystematic reviews and eta-nalyses guidelines, and the Cochrane risk-of-bias tool and rading of ecommendations ssessment evelopment and valuation recommendations for quality of evidence were used to rate all included publications.
RESULTS
The LAT groups showed significant improvement, compared with control groups when full response rates were analyzed. There was no significant difference between the groups treated with LAT and the groups who underwent medication therapy alone when full response rates were analyzed. Red and infrared wavelengths and continuous waves were the most commonly used LAT modalities, and lower abdomen and back acupoints were the most-common sites.
CONCLUSIONS
LAT seems to be an effective and safe treatment for NE; however, the quality of evidence available in the literature was relatively low. More-rigorous and higher-quality trials are needed to investigate this treatment modality further.
PubMed: 36046465
DOI: 10.1089/acu.2022.0002 -
Journal of the Royal Society of Medicine Aug 1983
Topics: Behavior Therapy; Child; Enuresis; Humans; Imipramine
PubMed: 6887185
DOI: 10.1177/014107688307600802 -
F1000Research 2017Enuresis, particularly in children during sleep, can be a debilitating condition, affecting the quality of life of the child and his or her family. The pathophysiology... (Review)
Review
Enuresis, particularly in children during sleep, can be a debilitating condition, affecting the quality of life of the child and his or her family. The pathophysiology of nocturnal enuresis, though not clear, revolves around the inter-related mechanisms of overactive bladder, excessive nocturnal urine production, and sleep fragmentation. The first mechanism is more related to isolated nocturnal voiding, whereas the latter two are more related to nocturnal enuresis, in which circadian variations in arginine vasopressin hormone play a key role. A successful treatment would depend upon appropriately addressing the key factors precipitating nocturnal enuresis, necessitating an accurate diagnosis. Thus, advancements in diagnostic tools and treatment options play a key role in achieving overall success. This review summarizes recent advances in understanding the pathophysiology of nocturnal enuresis, diagnostic tools, and treatment options which can be explored in the future.
PubMed: 29123651
DOI: 10.12688/f1000research.11303.1 -
Indian Journal of Nephrology 2017Nocturnal enuresis is a common problem affecting school-aged children worldwide. Although it has significant impact on child's psychology, it is always under-recognized... (Review)
Review
Nocturnal enuresis is a common problem affecting school-aged children worldwide. Although it has significant impact on child's psychology, it is always under-recognized in India and considered as a condition which will outgrow with advancing age. Nocturnal enuresis classified as primary or secondary and monosymptomatic or nonmonosymptomatic. Factors that cause enuresis include genetic factors, bladder dysfunction, psychological factors, and inappropriate antidiuretic hormone secretion, leading to nocturnal polyuria. Diagnosis consists of detailed medical history, clinical examination, frequency-volume charts, and appropriate investigations. The frequency-volume chart or voiding diary helps in establishing diagnosis and tailoring therapy. The first step in treating nocturnal enuresis is to counsel the parents and the affected child about the condition and reassure them that it can be cured. One of the effective strategies to manage enuresis is alarm therapy, but currently, it is not easily available in India. Desmopressin has been used in the treatment of nocturnal enuresis for close to 50 years. It provides an effective and safe option for the management of nocturnal enuresis. This review covers the diagnosis and management of nocturnal enuresis and introduces the concept of "bedwetting clinics" in India, which should help clinicians in the thorough investigation of bedwetting cases.
PubMed: 29217876
DOI: 10.4103/ijn.IJN_288_16 -
Experimental Biology and Medicine... Jul 2021Nocturnal enuresis is a common and distressing developmental disease, which may cause various degrees of psychosocial stress and impairment to self-esteem in affected... (Review)
Review
Nocturnal enuresis is a common and distressing developmental disease, which may cause various degrees of psychosocial stress and impairment to self-esteem in affected children as well as agitation to their parents or caregivers. Nevertheless, the etiology and pathogenesis of nocturnal enuresis are not understood. Currently, nocturnal enuresis is generally considered a multifactorial disease associated with a complex interaction of somatic, psychosocial, and environmental factors. A variety of postulations have been proposed to explain the occurrence and progression of nocturnal enuresis, including hereditary aberration, abnormal circadian rhythm of antidiuretic hormone secretion during sleep, bladder dysfunction, abnormal sleep, difficulties in arousal, neuropsychological disorders, and maturational delays of the brain. In recent decades, the introduction of functional neuroimaging technologies has provided new approaches for uncovering the mechanisms underlying nocturnal enuresis. The main neuroimaging modalities have included brain morphometry based on structural magnetic resonance imaging (MRI), task-based and event-related functional MRI (fMRI), and resting-state fMRI. The relevant studies have indicated that nocturnal enuresis is associated with functional and structural alterations of the brain. In this review, we briefly summarized the popular hypotheses regarding the pathogenesis of nocturnal enuresis and the current progress of functional neuroimaging studies in examining the underlying mechanisms thereof.
Topics: Brain; Circadian Rhythm; Humans; Magnetic Resonance Imaging; Nocturnal Enuresis
PubMed: 33715529
DOI: 10.1177/1535370221997363 -
American Family Physician Mar 1999Primary nocturnal enuresis sometimes presents significant psychosocial problems for children and their parents. Causative factors may include maturational delay, genetic... (Review)
Review
Primary nocturnal enuresis sometimes presents significant psychosocial problems for children and their parents. Causative factors may include maturational delay, genetic influence, difficulties in waking and decreased nighttime secretion of antidiuretic hormone. Anatomic abnormalities are usually not found, and psychologic causes are unlikely. Evaluation of enuresis usually requires no more than a complete history, a focused physical examination, and urine specific gravity and dipstick tests. Nonpharmacologic treatments include motivational therapy, behavioral conditioning and bladder-training exercises. Pharmacologic therapy includes imipramine, anticholinergic medication and desmopressin. These drugs have been used with varying degrees of success.
Topics: Enuresis; Humans; Patient Education as Topic; Teaching Materials
PubMed: 10088876
DOI: No ID Found -
World Journal of Nephrology Jul 2016Nocturnal enuresis often causes considerable distress or functional impairment to patient and their parents necessitating a multidisciplinary approach from... (Review)
Review
Nocturnal enuresis often causes considerable distress or functional impairment to patient and their parents necessitating a multidisciplinary approach from paediatrician, paediatric nephrologist, urologists and psychiatrist. Mechanisms of monosymptomatic nocturnal enuresis are mainly nocturnal polyuria, bladder overactivity and failure to awaken from sleep in response to bladder sensations. Goal oriented and etiology wise treatment includes simple behavioral intervention, conditioning alarm regimen and pharmacotherapy with desmopressin, imipramine and anticholinergic drugs. Symptoms often recurs requiring change over or combination of different modes of treatment.
PubMed: 27458562
DOI: 10.5527/wjn.v5.i4.328 -
Journal of Developmental and Behavioral... 2015To derive latent classes (longitudinal "phenotypes") of frequency of bedwetting from 4 to 9 years and to examine their association with developmental delay, parental...
OBJECTIVE
To derive latent classes (longitudinal "phenotypes") of frequency of bedwetting from 4 to 9 years and to examine their association with developmental delay, parental history of bedwetting, length of gestation and birth weight.
METHOD
The authors used data from 8,769 children from the U.K. Avon Longitudinal Study of Parents and Children cohort. Mothers provided repeated reports on their child's frequency of bedwetting from 4 to 9 years. The authors used longitudinal latent class analysis to derive latent classes of bedwetting and examined their association with sex, developmental level at 18 months, parental history of wetting, birth weight, and gestational length.
RESULTS
The authors identified 5 latent classes: (1) "normative"-low probability of bedwetting; (2) "infrequent delayed"-delayed attainment of nighttime bladder control with bedwetting
bedwetting ≥ twice a week; (4) "infrequent persistent"-persistent bedwetting < twice a week; and (5) "frequent persistent"-persistent bedwetting ≥ twice a week. Male gender (odds ratio = 3.20 [95% confidence interval = 2.36-4.34]), developmental delay, for example, delayed social skills (1.33 [1.11-1.58]), and maternal history of wetting (3.91 [2.60-5.88]) were associated with an increase in the odds of bedwetting at 4 to 9 years. There was little evidence that low birth weight and shorter gestation period were associated with bedwetting. CONCLUSION
The authors described patterns of development of nighttime bladder control and found evidence for factors that predict continuation of bedwetting at school age. Increased knowledge of risk factors for bedwetting is needed to identify children at risk of future problems attaining and maintaining continence.
Topics: Child; Child, Preschool; Female; Gestational Age; Humans; Infant, Low Birth Weight; Longitudinal Studies; Male; Nocturnal Enuresis; Risk Factors; Sex Factors; Social Skills
PubMed: 26468941
DOI: 10.1097/DBP.0000000000000229 -
Investigative and Clinical Urology May 2022
Topics: Female; Humans; Male; Nocturnal Enuresis; Urinary Bladder
PubMed: 35534213
DOI: 10.4111/icu.20220093