Enuresis Management in Children: Retrospective Clinical Audit of 2861 Cases Treated with Practitioner-Assisted Bell-and-Pad Alarm

Apos, Esther; Reece, John; Whitaker, Shirley; Murphy, Kerry; Golder, John; Leiper, Beverley; Sullivan, Linda; Gibb, Susan

doi:10.1016/j.jpeds.2017.09.086

Cited by 23 publications

(13 citation statements)

References 21 publications

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“…Treatment continues until the child remains dry for 14 consecutive days, with a maximum treatment duration of 16 weeks (see Figure for the therapy algorithm). According to a new retrospective study, 76% of children attain dryness within 9 weeks of treatment, with a relapse rate of 23% (25).…”

Section: Enuresismentioning

confidence: 99%

The Diagnosis and Treatment of Enuresis and Functional Daytime Urinary Incontinence

Gontard¹,

Kuwertz-Bröking²

2019

Deutsches Ärzteblatt International

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limination disorders are common, well treatable childhood disorders, associated with high levels of distress and increased rates of psychiatric and other comorbid disorders (1). Despite a spontaneous recovery rate of 15% per year, they can continue into adolescence (2, 3). Therefore, early and effective treatment is important. The prerequisite for an effective therapy is a precise, specific diagnosis of the respective elimination disorder. Two major groups can be distinguished: nocturnal enuresis and daytime urinary incontinence. About 10% of seven-year-olds wet at night, and up to 6% during the day (4). The classification systems of ICD-10 (5) and DSM-5 (6) are not up-to-date and do not allow the different subtypes of elimination disorder to be adequately differentiated (7). As a result, the new international classification system of the International Children's Continence Society (ICCS) (8) has become particularly important, as it takes into account the current state of research. The purpose of this article is to provide a current, practical review of the workup and treatment of these common disorders. For further details, please refer to current English and German textbooks (9-11). Methods This selective review is based on current literature, the recommendations of the ICCS (8), and the interdisciplinary, consensus-based German S2K-AWMF guideline on enuresis and functional (non-organic) urinary incontinence (12). Results Classification: Enuresis and urinary incontinence The ICCS distinguishes between frequent, intermittent forms of wetting, which are predominantly nonorganic, and the rare, continuous forms of incontinence, which predominantly have organic causes (e.g., structural, neurogenic, infectious, or other pediatric illnesses) (8, 12). Two main groups can be distinguished for intermittent incontinence: nocturnal enuresis, and functional daytime urinary incontinence (Table 1). Nocturnal enuresis (or simply enuresis) refers to any intermittent wetting during sleep, which includes the afternoon nap. Non-organic (functional) daytime Summary 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.

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Section: Enuresismentioning

confidence: 99%

The Diagnosis and Treatment of Enuresis and Functional Daytime Urinary Incontinence

Gontard¹,

Kuwertz-Bröking²

2019

Deutsches Ärzteblatt International

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“…A result from Tsuji's study showed whether the parents or children themselves are waked by the alarm or the effectiveness of alarm is equal [30]. Apos E. et al's study published in 2018 stated excellent effects of alarm therapy for MNE, NMNE, PNE, and SNE children using alarm therapy and especially for NMNE children [31]. The ICCS guideline also recommended that the alarm should be considered as the therapeutic option for every child.…”

Section: Alarmmentioning

confidence: 99%

“…Although a large amount of evidence has shown the effectiveness of conventional treatment including alarm and pharmacotherapy on NE [31,45], these approaches cannot meet all the needs of the children and their parents. It is reported that as high as 30% of families discontinue the treatment of alarm on their own reason [46].…”

Section: Complementary and Alternative Approachesmentioning

confidence: 99%

Advances in Treatment of Nocturnal Enuresis in Children

Zhou¹,

Lü²,

Shi³

et al. 2020

Lower Urinary Tract Dysfunction - From Evidence to Clinical Practice

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Nocturnal enuresis is a condition with complex etiology affecting plenty of children and families. Even though multifarious clinical trials and studies have been designed and completed, some inconclusive results on nocturnal enuresis confuse clinicians. This article aims to provide useful information for clinicians by summarizing the existing evidence on nocturnal enuresis and discussing the effectiveness and safety of different treatments. Nocturnal enuresis mainly results from the disorders related to central nervous system, which may cause nocturnal polyuria, nighttime bladder capacity decline, arousal disorder, and various accompanying diseases. We discussed the efficacy and safety of different treatments for monosymptomatic nocturnal enuresis, including standard therapies, simple behavioral interventions, complex behavioral interventions, alarm therapy, desmopressin and other drugs, biofeedback therapy, electrical stimulation, acupuncture, Chinese herbal medicine, massage, and so on. Alarm is still the most effective single therapy with lower relapse rate. Desmopressin has efficacy mainly in children with nocturnal polyuria. Children with detrusor overactivity or decreasing functional bladder capacity can choose anticholinergics. Additionally, tricyclic drugs, biofeedback therapy, electrical stimulation, acupuncture, massage, and so on are therapeutic options for children with nocturnal enuresis.

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“…En algunos países, la terapia con alarma es el tratamiento de primera línea para la enuresis, y la desmopresina solo se puede prescribir cuando la terapia de alarma no ha tenido éxito o se ha considerado inadecuada. 47 La constancia es crucial y la alarma debe ser usada cada noche. La respuesta no es inmediata y la terapia se continúa por dos o tres meses o hasta que el niño llegue a estar seco por 14 noches consecutivas.…”

Section: Opciones Terapéuticas De Primera Línea 5) ¿Cuál Es El Mecaniunclassified

“…Recientemente, se han informado muy buenos resultados con bell and pad conditioning alarm. 47 Sin embargo, en algunas regiones, la aceptabilidad del paciente de estos dispositivos es una gran limitación. 54 En estas latitudes, la utilización de la alarma es de baja frecuencia, tal vez, debido a la falta de experiencia en su uso y a la falta de motivación o aceptación de los padres, quizá, por la escasa información que reciben del profesional.…”

Section: Opciones Terapéuticas De Primera Línea 5) ¿Cuál Es El Mecaniunclassified

Adaptación en español de la “Guía de enuresis monosintomática”

Sager¹

2018

Arch Argent Pediatr

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Adaptación en español de la "Guía de enuresis monosintomática" / S93 RESUMEN El objetivo general es adaptar las recomendaciones del abordaje de enuresis primaria monosintomática (EM) al contexto regional. Se utilizaron los instrumentos "Guía para la adaptación de guías de práctica clínica" y "Lineamientos para la elaboración de consensos" (Sociedad Argentina de Pediatría). EM se denomina a la incontinencia urinaria intermitente durante el sueño en niños > 5 años de edad, sin otro síntoma urinario. Se diferencia de la enuresis no monosintomática, que se acompaña de otros síntomas del tracto urinario bajo, principalmente, durante el día. La EM es una afección transitoria y de resolución espontánea, por lo que la decisión de iniciar tratamiento debe ser consensuada con el niño y su entorno familiar. El pediatra de atención primaria debe ser el primer contacto con un niño con EM, quien implemente las conductas generales iniciales y la eventual indicación de medicación específica de primera línea, como alarma y desmopresina.

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Enuresis Management in Children: Retrospective Clinical Audit of 2861 Cases Treated with Practitioner-Assisted Bell-and-Pad Alarm

Cited by 23 publications

References 21 publications

The Diagnosis and Treatment of Enuresis and Functional Daytime Urinary Incontinence

The Diagnosis and Treatment of Enuresis and Functional Daytime Urinary Incontinence

Advances in Treatment of Nocturnal Enuresis in Children

Adaptación en español de la “Guía de enuresis monosintomática”

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