Pediatric Nephrology

, Volume 20, Issue 9, pp 1343–1345

Management of nocturnal enuresis in Greek children

  • A. Triantafyllidis
  • S. Charalambous
  • A. G. Papatsoris
  • A. Papathanasiou
  • C. Kalaitzis
  • V. Rombis
  • S. Touloupidis
Brief Report

Abstract

Our experiences of managing nocturnal enuresis in Greek children at our Outpatient Clinics of Pediatric Urology are described. Between March 2001 and October 2003, 142 children with primary nocturnal enuresis (93 boys and 49 girls), aged 7–18 years old (mean: 9.0±0.5) were included in this prospective study. Initially, behavioral conditioning therapy, using a body-worn urinary alarm, was instructed in all cases. If no improvement was recorded, 40 μg of intranasal desmopressin was administered, initially for three months. If urodynamic studies demonstrated pure detrusor instability, anticholinergics (5 mg oxybutinine or 2 mg tolterodine) were given instead. Combination medication (desmopressin and anticholinergics) was administered for coexisting diurnal enuresis, which was present in 8 children. Among the 142 children the overall response rate was 51.41%. Successful response was recorded in 16 children practicing conditioning behavioral therapy, in 47 receiving desmopressin (with or without anticholinergics), and in 10 children receiving only anticholinergics. During the follow-up period (mean: 6.2 months), no serious side effect was recorded. The use of desmopressin, and anticholinergics in specific subgroups, was found to be effective and safe for the management of nocturnal enuresis in children.

Keywords

Nocturnal enuresis Bedwetting Urinary alarm Desmopressin Anticholinergics 

References

  1. 1.
    Yeung CK (2003) Nocturnal enuresis (bedwetting). Curr Opin Urol 13:337–343CrossRefPubMedGoogle Scholar
  2. 2.
    Kuznetsova AA, Shakhmatova EI, Prutskova NP, Natochin YV (2000) Possible role of prostaglandins in pathogenesis of noctural enuresis in children. Scand J Urol Nephrol 34:27–31CrossRefPubMedGoogle Scholar
  3. 3.
    Bauer SB, Koff SA, Jayanthi VR (2002) Voiding dysfunction in children: neurogenic and non-neurogenic. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ (eds) Campbell’s urology. Saunders, Philadelphia, PA, pp 2261–2283Google Scholar
  4. 4.
    Hjalmas K (2002) Enuresis in children. Braz J Urol 28:232–249Google Scholar
  5. 5.
    Nørgaard JP, Pedersen EB, Djurhuus JC (1985) Diurnal anti-diuretic hormone levels in enuretics. J Urol 134:1029–1031Google Scholar
  6. 6.
    Moffatt ME, Harlos S, Kirshen AJ, Burd L (1993) Desmopressin acetate and nocturnal enuresis—how much do we know? Pediatrics 92:420–425PubMedGoogle Scholar
  7. 7.
    Riccabona M, Oswald J, Glauninger P (1998) Long-term use and tapered dose reduction of intranasal desmopressin in the treatment of enuretic children. Br J Urol 81(Suppl 3):24–25PubMedGoogle Scholar
  8. 8.
    Hjalmas K, Sillen U, Hanson E, Kruse S, Hellstrom A (1998) Long-term treatment with desmopressin of children with primary monosymptomatic nocturnal enuresis—an open multicentre study. Brit J Urol 82:704–709CrossRefPubMedGoogle Scholar
  9. 9.
    Wolfish NM, Barkin J, Gorodzinsky F, Schwarz R (2003) The Canadian Enuresis Study and Evaluation—short- and long-term safety and efficacy of an oral desmopressin preparation. Scand J Urol Nephrol 37:22–27CrossRefPubMedGoogle Scholar
  10. 10.
    Cigna RM, Chiaramonte C, Piscopo A, Cataliotti F (2002) Urodynamic evaluation in children with enuresis. Pediatr Med Chir 24:363–367PubMedGoogle Scholar

Copyright information

© IPNA 2005

Authors and Affiliations

  • A. Triantafyllidis
    • 1
  • S. Charalambous
    • 2
  • A. G. Papatsoris
    • 3
  • A. Papathanasiou
    • 2
  • C. Kalaitzis
    • 1
  • V. Rombis
    • 2
  • S. Touloupidis
    • 1
  1. 1.Department of Urology, School of MedicineDemocritus University of Thrace, University Hospital of AlexandroupolisAlexandroupolisGreece
  2. 2.Department of UrologyHippokrateion General HospitalThessalonikiGreece
  3. 3.Department of Urology, School of MedicineUniversity of Athens, Sismanogleio General HospitalAthensGreece

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