Avoid common mistakes on your manuscript.
To the Editor: We are grateful for your comments and queries related to our article [1].
-
1.
The normal expected urinary bladder capacity for children varies with age and can be calculated using the formula:-
$$ \left(\mathrm{Age}\ \mathrm{in}\kern0.35em \mathrm{years}+2\right)\times 30\;\mathrm{mL}. $$This can then be compared to the voided volume. It is considered small if the voided volume is < 65 % for the expected capacity for age [2].
-
2.
Smaller than expected bladder capacity are desmopressin resistant because the likely etiology in these children is not overproduction of urine. Hence the response to desmopressin is likely to be poor. Nocturnal polyuria is now described in some children with enuresis who respond to desmopressin. Here the overnight urine output is >130 % of expected bladder capacity. Children with smaller than expected bladder capacity do better with anticholinergics. However, in case we can document nocturnal polyuria as well as a reduced bladder capacity the two modalities can be used with synergistic effect [3].
I hope we have been able to satisfy the queries raised.
References
Kanitkar M, Ramamurthy HR. Bed wetting-silent suffering: An approach to enuresis and voiding disorders in children. Indian J Pediatr. 2013;80:750–3.
Ramamurthy HR, Kanitkar M. Non invasive urodynamic assessment in children–are they reliable? Validation of non-invasive urodynamics in children with functional voiding disorders. Indian J Pediatr. 2010;77:1400–4.
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. Practical consensus guidelines for the management of enuresis. Eur J Pediatr. 2012;171:971–83.
Contribution
Dr. Madhuri Kanitkar will act as guarantor for the paper.
Conflict of Interest
None.
Role of Funding Source
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kanitkar, M., Ramamurthy, H.R. Bed Wetting—Silent Suffering: An Approach to Enuresis and Voiding Disorders in Children: Authors’ Reply. Indian J Pediatr 81, 740 (2014). https://doi.org/10.1007/s12098-013-1320-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-013-1320-4