Clinical behavioral problems in day- and night-wetting children

Gontard, Alexander von; Mauer-Mucke, K.; Plück, Julia; Berner, Wolfgang; Lehmkuhl, Gerd

doi:10.1007/s004670050677

Cited by 91 publications

(24 citation statements)

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“…In cases of nonmonosymptomatic enuresis, however, some studies have shown that this does not occur, with the frequency of enuresis tending to remain the same in older children, possibly as a consequence of the mechanisms involved in overactive bladder (11, 12, 15). Accordingly, the present study also failed to detect any reduction in enuresis with increasing age in non-monosymptomatic enuresis.…”

Section: Discussionmentioning

confidence: 99%

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Enuresis and overactive bladder in children: what is the relationship between these two conditions?

et al. 2016

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Objective:Evaluate clinical aspects associated with the presence of nocturnal enuresis (NE) in children with a diagnosis of overactive bladder (OAB).Material and Methods:A data base of 200 children who were evaluated by a structured questionnaire was analysed retrospectively . OAB was defined as the presence of urinary urgency (n=183 cases) and/or daytime urinary incontinence associated with holding maneuvers (n=168 cases). Inclusion criteria were a confirmed diagnosis of OAB, age 5-16 years, and no anatomical or neurological alterations of the urinary tract. Patients were divided into enuretics and non-enuretics. The two groups were compared with respect to sex, age, skin color, presence urinary infection, urgency, urge incontinence, non-urge incontinence, pollakiuria, urinary dysfunction, nocturia, holding maneuvers, number of episodes of enuresis and bowel alterations. In a univariate analysis, the chi-square test was used to compare proportions, with p-values <0.05 being considered significant. A multivariate analysis was conducted to identify independent predictive factors.Results:Enuresis was diagnosed in 141/200 children. The two groups were similar with respect to sex, age and skin color. No difference was found in relation to urinary infection, non-urge incontinence, urinary dysfunction, nocturia, encopresis or constipation. The two groups were significantly different with regard to some symptoms related to OAB such as urgency (p=0.001), urge incontinency (p=0.001) and holding maneuvers (p=0.033). Following multivariate analysis, only holding maneuvers (p=0.022) remained as an independent predictive factor.Conclusion:The only independent predictive factor for resolution of enuresis in children with OAB, as detected in the multivariate analysis, was holding maneuvers.

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Section: Discussionmentioning

confidence: 99%

“…Non-MSE is more commonly associated with urinary tract infections (UTI), vesicoureteral reflux, constipation and behavioral problems (11, 12). Parents often believe that their child's treatment has failed entirely when enuresis persists even though complete resolution of LUTS was achieved.…”

Section: Introductionmentioning

confidence: 99%

Enuresis and overactive bladder in children: what is the relationship between these two conditions?

et al. 2016

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“…We talk about primary enuresis when a child older than 5 years continues to wet bed during the sleep and there are no other diseases of the nervous, urogenital and endocrine systems detected [3]. It is estimated that 80% of children with nocturnal enuresis have this form.…”

Section: Definition and Classificationsmentioning

confidence: 99%

Nocturnal Enuresis as a Specific Compensatory Syndrome

Golbin¹

2017

AJCEM

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Abstract:The pathophysiological nature of the monosymptomatic primary nocturnal enuresis (PNE) in children is still the unresolved problem. The most hypotheses of pathogenesis of nocturnal enuresis are limited within anatomical, biochemical and physiological regulation of the urinary control. Based on our own observations as well as the data reported in the literature, we have concluded that in addition to described biological causes of this disorder, we should focus on the common clinical and developmental features observed in the majority of cases of the monosymptomatic primary nocturnal enuresis that could be united as "enuretic syndrome". In attempt to move "outside of the box" of the urinary control we have put forward a hypothesis that enuresis is a specific compensatory syndrome which is self-developed by the child's organism to "offset" the deviated sleepwake mechanisms. This concept is based on the general "control system theory" and offers the explanations of the majority of symptoms. From the compensatory "offset" concept the treatment of PNE should be focused not on the suppression of the act of enuresis but on the stabilization of circadian sleep-wake mechanisms. Further investigations are needed to evaluate the validity of this concept.

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“…Moreover the risk of psychosocial comorbidity is higher in therapy-resistant enuresis 11. Refractory NE is defined as less than 50% improvement in symptoms with an adequate trial of treatment (3 months) 12…”

Section: Introductionmentioning

confidence: 99%

Sleep apnea in children with refractory monosymptomatic nocturnal enuresis

El‐Mitwalli¹,

Bediwy²,

Zaher³

et al. 2014

NSS

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BackgroundChildren with nocturnal enuresis (NE) are believed to have deep sleep with high arousal threshold. Studies suggest that obstructive sleep apnea–hypopnea syndrome (OSAHS) and NE are common problems during childhood. We sought to assess the prevalence of OSAHS in children with refractory NE and whether its severity is associated with the frequency of bedwetting.MethodsThe study group comprised 43 children with refractory monosymptomatic NE and a control group of 30 children, both aged 6–12 years. All subjects underwent thorough neurological examination, one night of polysomnography only for the patient group, and a lumbosacral plain X-ray to exclude spina bifida.ResultsThe groups were well matched. Two subjects of the control group had mild OSAHS. The mean age of the patients was (9.19±2.4 years), 26 were boys, and 67% showed frequent NE (>3 days bedwetting/week). Patients with NE had significantly higher rates of OSAHS (P<0.0001); three patients had mild, 12 had moderate, and eleven showed severe OSAHS. There was no significant statistical difference among patients having OSAHS in relation to age, sex, or family history of NE. The frequency of bedwetting was statistically significantly higher in patients with severe OSAHS (P=0.003).ConclusionPatients with refractory NE had a significantly higher prevalence of OSAHS with no sex difference. The frequency of bedwetting was higher in patients with severe OSAHS.

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Clinical behavioral problems in day- and night-wetting children

Cited by 91 publications

References 20 publications

Enuresis and overactive bladder in children: what is the relationship between these two conditions?

Enuresis and overactive bladder in children: what is the relationship between these two conditions?

Nocturnal Enuresis as a Specific Compensatory Syndrome

Sleep apnea in children with refractory monosymptomatic nocturnal enuresis

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