Examination of the Structured Withdrawal Program to Prevent Relapse of Nocturnal Enuresis

Butler, Richard J.; Holland, Philip; Robinson, Joanne C

doi:10.1016/s0022-5347(05)65617-0

Cited by 37 publications

(15 citation statements)

References 19 publications

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“…If the child does not achieve complete dryness, or if wetting resumes once treatment is withdrawn, it should be continued/resumed. There is some evidence that structured withdrawal of medication may reduce relapse rates following its discontinuation [4, 29]. If a second voiding diary indicates nocturnal urinary production is not reduced, consider a dose increase (if maximum recommended dose has not been reached); otherwise, refer the child to a specialist.…”

Section: Desmopressin Therapymentioning

confidence: 99%

Practical consensus guidelines for the management of enuresis

et al. 2012

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Despite the high prevalence of enuresis, the professional training of doctors in the evaluation and management of this condition is often minimal and/or inconsistent. Therefore, patient care is neither optimal nor efficient, which can have a profound impact on affected children and their families. Once comprehensive history taking and evaluation has eliminated daytime symptoms or comorbidities, monosymptomatic enuresis can be managed efficaciously in the majority of patients. Non-monosymptomatic enuresis is often a more complex condition; these patients may benefit from referral to specialty care centers. We outline two alternative strategies to determine the most appropriate course of care. The first is a basic assessment covering only the essential components of diagnostic investigation which can be carried out in one office visit. The second strategy includes several additional evaluations including completion of a voiding diary, which requires extra time during the initial consultation and two office visits before treatment or specialty referral is provided. This should yield greater success than first-line treatment. Conclusion: This guideline, endorsed by major international pediatric urology and nephrology societies, aims to equip a general pediatric practice in both primary and secondary care with simple yet comprehensive guidelines and practical tools (i.e., checklists, diary templates, and quick-reference flowcharts) for complete evaluation and successful treatment of enuresis.

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Section: Desmopressin Therapymentioning

confidence: 99%

Practical consensus guidelines for the management of enuresis

et al. 2012

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“…Thus, removing the alarm or medication removes what the child believes to be the reason for success, and relapse consequently follows. Recently, Butler et al [91] reported an 8-week withdrawal programme speci®cally designed for preventing relapse on removal of medication. The programme focuses on engaging the child in a process of internalizing success and highlighting the effective process by which this is accomplished, whether it be increased arousability or improved AVP release.…”

Section: Preventing Relapsementioning

confidence: 99%

Treatment of childhood nocturnal enuresis: an examination of clinically relevant principles

Butler¹,

Stenberg

2001

BJU International

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“…Consiste en administrar la dosis completa de fármaco, disminuyendo quincenalmente los días de tratamiento hasta suspenderlo. Es una terapia conductual que añade un efecto curativo a la finalización del tratamiento con desmopresina 12 .…”

Section: ¿Cómo Mejorar Los Resultados Con Desmopresina?unclassified