Nocturnal enuresis: etiology, management and the impact on different age groups

Authors

  • Wedyan Salem Basaif Department of Urology, King Fahad General Hospital, Jeddah, Saudi Arabia
  • Atheer Marzouq Alamri College of Medicine, Ibn Sina National College, Jeddah, Saudi Arabia
  • Abdualrhman Ali Alamri Department of Urology, King Abdullah Medical Complex, Jeddah, Saudi Arabia
  • Mohammed Wasel Alkhudhayri College of Medicine, Medical University of Lodz, Lodz, Poland
  • Abdulrahman Mohammed Alamri Department of Urology, Armed Forces Hospital Southern Region, Abha, Saudi Arabia
  • Abdulrahim Mohammed Alamri Department of Urology, Wadi Aldawasir Armed Forces Hospital, Wadi Aldawasir, Saudi Arabia
  • Bandar Omar Alsahn Department of Urology, King Fahad Medical City, Riyadh, Saudi Arabia
  • Abdullah Zamil Almani Department of Urology, Security Forces Hospital, Riyadh, Saudi Arabia
  • Mahdi Abdullah Alayafi Department of Urology, Armed Forces Hospital Southern Region, Abha, Saudi Arabia
  • Mohanad Jebril Bosili Department of Urology, Armed Forces Hospital Southern Region, Abha, Saudi Arabia
  • Ahmed Abdulrahman Alshehri College of Medicine, Vision Colleges, Riyadh, Saudi Arabia

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20212346

Keywords:

Nocturnal enuresis, Pediatrics, Management, Epidemiology, Etiology

Abstract

Nocturnal enuresis or night time incontinence is a common condition that usually affects children and can be associated with significant psychological effects on the affected child if left untreated. It can be defined as night time wetting of the bed that usually occurs in children that are ≥5 years old. In this literature review, the aim was to discuss the etiology and management of nocturnal enuresis and the impact of the condition on the different age groups. Management of the underlying comorbidities, taking care of the overactive bladder and dealing with the potential psychological conditions might be the main key factors to nocturnal enuresis. Many pharmacological and non-pharmacological approaches have been proposed for these patients. However, the success rates of applying behavioral management approaches have been reported to be the highest as compared to other approaches. Early interventions should be applied for children that have multiple risk factors or with parents that once suffered from the condition as genetics were reported in the literature to have a significant role in the development of nocturnal enuresis. Pharmacological therapies have also been reported as effective modalities in resistant cases and desmopressin was reported to achieve a 100% success rate if used with alarm therapy. However, clinicians should care for the potential adverse events when approaching the pharmacological modalities.

References

Nevéus T, Gontard AV, Hoebeke P, Hjälmås K, Bauer S, Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the international children's continence society. J Urol. 2006;176(1):314-24.

Butler RJ, Heron J. The prevalence of infrequent bedwetting and nocturnal enuresis in childhood. A large British cohort. Scand J Urol Nephrol. 2008;42(3):257-64.

Gontard AV, Heron J, Joinson C. Family history of nocturnal enuresis and urinary incontinence: results from a large epidemiological study. J Urol. 2011;185(6):2303-6.

Shreeram S, He JP, Kalaydjian A, Brothers S, Merikangas KR. Prevalence of enuresis and its association with attention-deficit/hyperactivity disorder among U.S. children: results from a nationally representative study. J Am Acad Child Adolesc Psychiatry. 2009;48(1):35-41.

Sureshkumar P, Jones M, Caldwell PH, Craig JC. Risk factors for nocturnal enuresis in school-age children. J Urol. 2009;182(6):2893-9.

Fagundes SN, Lebl AS, Soster LA, Sousa ESGJ, Silvares EF, Koch VH. Monosymptomatic nocturnal enuresis in pediatric patients: multidisciplinary assessment and effects of therapeutic intervention. Pediatr Nephrol. 2017;32(5):843-51.

Thurber S. Childhood enuresis: current diagnostic formulations, salient findings, and effective treatment modalities. Archiv Psychiat Nurs. 2017;31(3):319-23.

Graham KM, Levy JB. Enuresis. pediatrics in review. Am Aca Paediat. 2009;30(5):165-72.

Herzeele CV, Bruyne PD, Bruyne ED, Walle JV. Challenging factors for enuresis treatment: Psychological problems and non-adherence. J Pediatr Urol. 2015;11(6):308-13.

Ferrara P, Autuori R, Dosa F, Lucia AD, Gatto A, Chiaretti A. Medical comorbidity of nocturnal enuresis in children. Indian J Nephrol. 2019;29(5):345-52.

Zaffanello M, Piacentini G, Lippi G, Fanos V, Gasperi E, Nosetti L. Obstructive sleep-disordered breathing, enuresis and combined disorders in children: chance or related association? Swiss Med Wkly. 2017;147:14400.

Kiddoo DA. Nocturnal enuresis. CMAJ Canadian Med Assoc J. 2012;184(8):908-11.

Makari J, Rushton HG. Nocturnal enuresis in children. Clinic Evid. 2006;15:486-95.

Caldwell PH, Deshpande AV, Gontard AV. Management of nocturnal enuresis. BMJ. 2013;347:6259.

Kamperis K, Rittig S, Jørgensen KA, Djurhuus JC. Nocturnal polyuria in monosymptomatic nocturnal enuresis refractory to desmopressin treatment. Am J Physiol Renal Physiol. 2006;291(6):1232-40.

Rittig S, Knudsen UB, Nørgaard JP, Pedersen EB, Djurhuus JC. Abnormal diurnal rhythm of plasma vasopressin and urinary output in patients with enuresis. Am J Physiol. 1989;256:664-71.

Thieu H, Dat BB, Nam NH, Reda A, Duc Nt, Alshareef A, et al. Antibiotic resistance of Helicobacter pylori infection in a children's hospital in Vietnam: prevalence and associated factors. Minerva Medica. 2020;111(5):498-501.

Yeung CK, Chiu HN, Sit FK. Bladder dysfunction in children with refractory monosymptomatic primary nocturnal enuresis. J Urol. 1999;162:1049-54.

Cohen-Zrubavel V, Kushnir B, Kushnir J, Sadeh A. Sleep and sleepiness in children with nocturnal enuresis. Sleep. 2011;34(2):191-4.

Kiddoo DA, Valentino RJ, Zderic S, Ganesh A, Leiser SC, Hale L, et al. Impact of state of arousal and stress neuropeptides on urodynamic function in freely moving rats. Am J Physiol. 2006;290(6):1697-706.

Aydil U, Işeri E, Kizil Y, Bodur S, Ceylan A, Uslu S. Obstructive upper airway problems and primary enuresis nocturna relationship in pediatric patients: reciprocal study. J Otolaryngol Head Neck Surg. 2008;37(2):235-9.

Nevéus T. Pathogenesis of enuresis: towards a new understanding. Int J Urol. 2017;24(3):174-82.

Franco I, Gontard AV, Gennaro MD, International Childrens's Continence Society. Evaluation and treatment of non-monosymptomatic nocturnal enuresis: a standardization document from the international children's continence society. J Pediatr Urol. 2013;9(2):234-43.

Vasconcelos MMA, East P, Blanco E, Lukacz ES, Caballero G, Lozoff B, et al. Early behavioral risks of childhood and adolescent daytime urinary incontinence and nocturnal enuresis. J Dev Behav Pediatr. 2017;38(9):736-42.

Kuwertz-Bröking E, Gontard AV. Clinical management of nocturnal enuresis. Pediatr Nephrol. 2018;33(7):1145-54.

Dossche L, Walle JV, Herzeele CV. The pathophysiology of monosymptomatic nocturnal enuresis with special emphasis on the circadian rhythm of renal physiology. Eur J Pediatr. 2016;175(6):747-54.

Walle JV, Rittig S, Bauer S, Eggert P, Marschall-Kehrel D, Tekgul S, et al. Practical consensus guidelines for the management of enuresis. Eur J Pediatr. 2012;171(6):971-83.

Dyk JCV, Duvenhage F, Coetzee LJ, Segone AM, Fockema M, Smart D, et al. South African guidelines for the management of nocturnal enuresis. S Afr Med. 2003;93(5):338-40.

Proserpio P, Terzaghi M, Manni R, Nobili L. Drugs used in parasomnia. Sleep Med Clin. 2018;13(2):191-202.

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

Downloads

Published

2021-06-25

How to Cite

Basaif, W. S., Alamri, A. M., Alamri, A. A., Alkhudhayri, M. W., Alamri, A. M., Alamri, A. M., Alsahn, B. O., Almani, A. Z., Alayafi, M. A., Bosili, M. J., & Alshehri, A. A. (2021). Nocturnal enuresis: etiology, management and the impact on different age groups. International Journal Of Community Medicine And Public Health, 8(7), 3703–3707. https://doi.org/10.18203/2394-6040.ijcmph20212346

Issue

Section

Review Articles