Medline ® Abstracts for References 4-6,16
of 'Nocturnal enuresis in children: Management'
Evaluation of and treatment for monosymptomatic enuresis: a standardization document from the International Children's Continence Society.
Neveus T, Eggert P, Evans J, Macedo A, Rittig S, Tekgül S, Vande Walle J, Yeung CK, Robson L, International Children's Continence Society
J Urol. 2010;183(2):441.
PURPOSE: We provide updated, clinically useful recommendations for treating children with monosymptomatic nocturnal enuresis.
MATERIALS AND METHODS: Evidence was gathered from the literature and experience was gathered from the authors with priority given to evidence when present. The draft document was circulated among all members of the International Children's Continence Society as well as other relevant expert associations before completion.
RESULTS: Available evidence suggests that children with monosymptomatic nocturnal enuresis could primarily be treated by a primary care physician or an adequately educated nurse. The mainstays of primary evaluation are a proper history and a voiding chart. The mainstays of primary therapy are bladder advice, the enuresis alarm and/or desmopressin. Therapy resistant cases should be handled by a specialist doctor. Among the recommended second line therapies are anticholinergics and in select cases imipramine.
CONCLUSIONS: Enuresis in a child older than 5 years is not a trivial condition, and needs proper evaluation and treatment. This requires time but usually does not demand costly or invasive procedures.
Nephrology Unit, Uppsala University Children's Hospital, Uppsala, Sweden. email@example.com
National Institute for Health and Care Excellence. Nocturnal enuresis - the management of bedwetting in children and young people. www.nice.org.uk/guidance/index.jsp?action=download&o=51367 (Accessed on February 28, 2011).
no abstract available
Paediatric Society New Zealand. Noctural Enuresis "Bedwetting," 2005. www.paediatrics.org.nz/files/guidelines/Enuresisguidelinefinalendorsed.pdf (Accessed on March 03, 2011).
no abstract available
Practical consensus guidelines for the management of enuresis.
Vande Walle J, Rittig S, Bauer S, Eggert P, Marschall-Kehrel D, Tekgul S, American Academy of Pediatrics, European Society for Paediatric Urology, European Society for Paediatric Nephrology, International Children’s Continence Society
Eur J Pediatr. 2012 Jun;171(6):971-83. Epub 2012 Feb 24.
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.
Pediatric Nephrology Unit, Ghent University Hospital, Ghent, Belgium. firstname.lastname@example.org