Nocturnal Enuresis: An International Evidence Based Management Strategy

Hjälmås, K; Arnold, Todd W.; Bower, Wendy; Caione, Paolo; Chiozza, L.M.; Gontard, Alexander von; Han, Sang Won; Husman, D.A.; Kawauchi, Akihiro; Läckgren, Göran; Lottmann, Henri; Mark, Steve; Rittig, Søren; Robson, Lane M.; Walle, Johan Vande; Yeung, Chung‐Kwong

doi:10.1097/01.ju.0000111504.85822.b2

Cited by 280 publications

(203 citation statements)

References 67 publications

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“…NE was the primary explanatory variable and was defined as intermittent urine incontinence while sleeping for at least one night per week in the absence of (i) other lower urinary tract symptoms (increased/decreased voiding frequency, daytime incontinence, urgency, hesitancy, straining, weak stream, intermittency, holding maneuvers, feeling of incomplete emptying, post-micturition dribble, and genital or lower urinary tract pain); (ii) history of bladder dysfunction; or (iii) a previous dry period of at least 6 mo (16,35). The cut-off value of at least one night per week was selected for consistency with previous population-based epidemiologic studies (6,7).…”

Section: Discussionmentioning

confidence: 99%

Nocturnal enuresis is associated with moderate-to-severe obstructive sleep apnea in children with snoring

et al. 2014

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Background: Conflicting data suggest that prevalence of monosymptomatic primary nocturnal enuresis (NE) increases with increasing severity of obstructive sleep apnea (OSA) in childhood and especially in girls. We hypothesized that NE is associated with increased risk of moderate-to-severe OSA (obstructive apnea-hypopnea index (AHI) >5 episodes/hour) among children with snoring. Methods: Data of children (≥5 y old) with snoring who were referred for polysomnography over 12 y were reviewed. results: Data of 525 children with mean age (±SD) 7.5 (± 2.2) y and median obstructive AHI (10th-90th percentiles) 1.9 (0.4-7.3) episodes/hour were analyzed. Three hundred and fifty-five children (67.6%) had NE and 87 (16.6%) had moderate-to-severe OSA. There was no interaction between NE and gender regarding the association with moderate-to-severe OSA (P > 0.05). NE was associated significantly with presence of moderate-to-severe OSA after adjustment for tonsillar hypertrophy, obesity, gender, and age (adjusted odds ratio = 1.92 (1.08-3.43); P = 0.03). Presence of NE had high sensitivity (78.2%) and low positive predictive value (19.2%) for detecting moderate-to-severe OSA and low specificity (34.5%) and high negative predictive value (88.8%) for ruling it out. conclusion: Children with snoring and without NE referred for polysomnography are less likely to have moderate-tosevere OSA compared to those with NE.

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Section: Discussionmentioning

confidence: 99%

Nocturnal enuresis is associated with moderate-to-severe obstructive sleep apnea in children with snoring

et al. 2014

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“…71,[74][75][76] Coercive or permissive methods of toilet training may be associated with the development of enuresis 22,77 and encopresis. 65 Analyzing the references identified, similarities can be observed between the recommendations, following the method described by Brazelton in 1962.…”

Section: Enuresismentioning

confidence: 99%

Treinamento esfincteriano: métodos, expectativas dos pais e morbidades associadas

Mota¹,

Barros²

2008

J. Pediatr. (Rio J.)

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Objective: To review both the scientific literature and lay literature on toilet training, covering parents' expectations, the methods available for achieving bladder and bowel control and associated morbidities. Summary of the findings:Parents have unrealistic expectations about the age at which diapers can be withdrawn, not taking child development into account. Toilet training strategies have not changed over recent decades, and in the majority of countries the age at which children are trained has been postponed. Training methods are rarely used.Starting toilet training prematurely and stressful events during this period can extend the training process. Children who have not been trained correctly present with enuresis, urinary infection, voiding dysfunction, constipation, encopresis and refusal to go to the toilet more frequently. Literature intended for lay parents is both abundant and adequate, available in book form and on the Internet, but it is not widely available to the Brazilian population. Just three international pediatrics societies have published guidelines on toilet training. Conclusions:Toilet training is occurring later in the majority of countries. The training methods that exist are the same from decades ago and are rarely used by mothers and valued little by pediatricians; incorrect training can be a causative factor for bladder and bowel disorders, which in turn cause problems for children and their families.J Pediatr (Rio J). 2008;84(1):9-17: Toilet training, enuresis, child, urinary tract infection, elimination disorders.

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“…7,8 Nighttime voiding habit is naturally acquired; therefore, it does not rely on learning, and it should take place around the age of 5 and a half years among girls and around the age of 6 years in boys. 9 The aim of this study is to assess sphincter control in the first four years of life in a birth cohort and to describe the factors (family, environmental, maternal, and those inherent to the child) that may be associated with it.…”

Section: Introductionmentioning

confidence: 99%

Avaliação longitudinal do controle esfincteriano em uma coorte de crianças Brasileiras

Mota¹,

Barros

Matijasevich

et al. 2010

J. Pediatr. (Rio J.)

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Objective: To analyze sphincter control acquisition in a birth cohort.Method: 4,231 children born in 2004 in Pelotas, Brazil, were included in a longitudinal study. During home visits at the ages of 12, 24 and 48 months, the mothers answered a questionnaire about sociodemographic questions and characteristics of their children's voiding and bowel habits, with special attention to toilet training. Results:At 48 months, most children were off diapers during the day (98.5%) and by night (83%), with no difference between sexes. The average age for starting toilet training was 22 months, with earlier initiation in girls. The training was, on average, 3.2 months long, showing no difference between sexes. Children with developmental delay had late voiding and bowel control; the higher the deviation from normality, the later the child was off diapers. Medical advice was given to 15.9% of mothers. The training initiated before the age of 24 months was inversely correlated with an older age of sphincter control and longer training. Premature and low birth weight children showed no significant difference in training time and age of acquisition of sphincter control. Conclusions:At the age of 48 months, most children, including premature and low birth weight ones, acquired sphincter control regardless of external factors and sex. The beginning of training (before 24 months) did not anticipate sphincter control, but only prolonged the duration of training.

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Nocturnal Enuresis: An International Evidence Based Management Strategy

Cited by 280 publications

References 67 publications

Nocturnal enuresis is associated with moderate-to-severe obstructive sleep apnea in children with snoring

Nocturnal enuresis is associated with moderate-to-severe obstructive sleep apnea in children with snoring

Treinamento esfincteriano: métodos, expectativas dos pais e morbidades associadas

Avaliação longitudinal do controle esfincteriano em uma coorte de crianças Brasileiras

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