AN OUTCOME OF CONSERVATIVE MANAGEMENT OF PRIMARY NOCTURNAL ENURESIS IN CHILDREN

Authors

  • Syed Sajid Hussain Shah Department of Paediatrics, Ayub Medical College Abbottabad
  • Bibi Aalia 2KMU Institute of Medical Sciences, Kohat-Pakistan
  • Ali Raza Department of Paediatrics, Ayub Medical College Abbottabad
  • Shahzad Najeeb Department of Paediatrics, Ayub Medical College Abbottabad
  • Anis-ur-Rehman Department of Paediatrics, Ayub Medical College Abbottabad

Abstract

Background: Primary nocturnal enuresis is one of the common problems in children. Mostly parents are concern for this condition in children and also children are depressive from this condition. The main stay of treatment is the training of child. The objective of this study was to look for the outcome of conservative management of primary nocturnal enuresis. Methods: This study was done in OPD of paediatrics department. Patients aged five year or more were included in the study. Patient age, weight, sex, blood pressure, family history in siblings and parents, number of wet days/week, recorded on specific proforma along with renal function tests. Patients were advised fluid restriction after evening and micturition before sleep and after 2–3 hours of sleep. Follow up was done after six months to observe for the impact of habit change. Data has been analysed by SPSS 20 and results are taken significant with p-value <0.05. Results: Out of 81 patients, 41 were male and 40 females. Age ranged from 5 to 14 years and mean age was 8.2±2.35 years. There were 11.1% parents who had primary nocturnal enuresis during childhood and in 29.6% siblings, history was positive. Follow up at 6 months, 58% patients improved while 42% showed no improvement. There was significant relationship between evening fluid restriction, micturition before and after sleep with improvement at 6 months with p-value of 0.010, <0.001 and 0.002 respectively. Conclusion: Conservative management is the effective intervention in children as parents should be emphasized for habit change. Keywords: Primary nocturnal enuresis; Children; Conservative management

References

Arda E, Cakiroglu B, Thomas DT. Primary Nocturnal Enuresis: A Review. Nephrourol Mon 2016;8(4):e35809.

Ramakrishnan K. Evaluation and treatment of enuresis. Am Fam Physician 2008;78(4):489–96.

Claudius G, Chhatwal J, Sohi I. Efficacy of alarm intervention in primary monosymptomatic nocturnal enuresis in children. Int J Contemp Pediatr 2016;3(2):621–4.

Naitoh Y, Kawauchi A, Soh J, Kamoi K, Miki T. Health related quality of life for monosymptomatic enuretic children and their mothers. J Urol 2012;188(5):1910–4.

Kanaheswari Y, Poulsaeman V, Chandran V. Self-esteem in 6- to 16-year-olds with monosymptomatic nocturnal enuresis. J Paediatr Child Health 2012;48(10):E178–82.

Deshpande AV, Caldwell PH, Sureshkumar P. Drugs for nocturnal enuresis in children (other than desmopressin and tricyclics). Cochrane Database Syst Rev 2012;12(12):CD002238.

Kwak KW, Lee YS, Park KH, Baek M. Efficacy of desmopressin and enuresis alarm as first and second line treatment for primary monosymptomatic nocturnal enuresis: prospective randomized crossover study. J Urol 2010;184(6):2521–6.

Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: Update report from the standardization committee of the international children’s continence society. J Urol 2014;191(6):1863–5.

Deshpande AV, Caldwell PH. Medical management of nocturnal enuresis. Paediatr Drugs 2012;14(2):71–7.

Schloss J, Ryan K, Reid R, Steel A. A randomized, double-blind, placebo controlled clinical trial assessing the efficacy of bedtime buddy® for the treatment of nocturnal enuresis in children. BMC Pediatr 2019;19(1):421.

Nuzhat H, Qadir I, Malik MTB, Nazar S. Outcome of combination therapy versus behavior therapy in treatment of nocturnal enuresis. J Univ Med Dent Coll 2017;8(4):7–13.

ElBaz F, Zahra S, Khairy M. Assessment of the efficacy of Desmopressin in treatment of Primary Monosymptomatic Nocturnal Enuresis in Egyptian children. Egypt J Med Hum Genet 2015;16(3):257–62.

Ma Y, Shen Y, Liu X. Association between enuresis and obesity in children with primary monosymptomatic nocturnal enuresis. Int Braz J Urol 2019;45(4):790–7.

Campos RM, Lúcio AC, Lopes MH, Hacad CR, Perissinotto MC, Glazer HI, et al. Pelvic floor muscle training alone or in combination with oxybutynin in treatment of non-monosymptomatic enuresis. A randomized controlled trial with 2-year follow up. Einstein (São Paulo) 2019;17(3):eAO4602.

Ma Y, Liu X, Shen Y. Behavioral factors for predicting severity of enuresis and treatment responses in different compliance groups receiving behavioral therapy. Pak J Med Sci 2017;33(4):953–8.

Chan IHY, Wong KKY. Common urological problems in children: primary nocturnal enuresis. Hong Kong Med J 2019;25(4):305–11.

Gontard AV, Kuwertz-Bröking E. The diagnosis and treatment of enuresis and functional daytime urinary incontinence. Dtsch Arztebl Int 2019;116(16):279–85.

Alwis US, Monaghan TF, Haddad R, Weiss JP, Roggeman S, Laecke EV, et al. Dietary considerations in the evaluation and management of nocturia. F1000Res 2020;9(F1000 Faculty Rev 165.

Sinha R, Raut S. Management of nocturnal enuresis – myths and facts. World J Nephrol 2016;5(4):328–38.

Published

2021-02-20

Most read articles by the same author(s)

1 2 > >>