enuresis
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Introduction
Urinary incontinence, intentional or involuntary not secondary to a physical disorder, frequently used in reference to children. Enuresis may be nocturnal (bed-wetting) or during wakefulness (diurnal eneresis). Nocturnal or sleep enuresis also occurs in adults.
Etiology
* asthma only allergic disease not associated with enuresis[6]
* among boys, only allergic rhinitis associated with enuresis[6]
Epidemiology
- 1-3% of adults
- 70% of mentally retarded adults
Management
- education to relieve guilt
- bladder training
- fluid restriction at night
- pharmaceutical agents
- do not use pharmaceutical therapy if child is < 7 years of age[4]
- desmopressin (DDAVP) tabs are effective in the majority of children
- avoid the nasal spray because it's easier for children to overdose & develop hyponatremia[4]
- if DDAVP is ineffective, consider
- imipramine (low dose)
- anticholinergic agent
More general terms
References
- ↑ nlmpubs.nlm.nih.gov/hstat/ahcpr/
- ↑ Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ 4.0 4.1 4.2 Prescriber's Letter 15(10): 2008 COMMENTARY: Treatment of Primary Nocturnal Enuresis (Bedwetting) in Children GUIDELINES: Assessment and Treatment of Enuresis in Children and Adolescents Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=241003&pb=PRL (subscription needed) http://www.prescribersletter.com
Fritz G et al; Work Group on Quality Issues; AACAP. Practice parameter for the assessment and treatment of children and adolescents with enuresis. J Am Acad Child Adolesc Psychiatry. 2004 Dec;43(12):1540-50. Review. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15564822 <Internet> http://www.aacap.org/galleries/PracticeParameters/Enuresis.pdf - ↑ Prescriber's Letter 19(4): 2012 Treatment of Primary Nocturnal Enuresis (Bedwetting) in Children Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=280407&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 6.0 6.1 6.2 6.3 Tsai J-D, Chen H-J, Ku M-S et al. Association between allergic disease, sleep-disordered breathing, and childhood nocturnal enuresis: A population-based case-control study. Pediatr Nephrol 2017 Dec; 32:2293. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28735503 https://link.springer.com/article/10.1007%2Fs00467-017-3750-0