| Primary monosymptomatic nocturnal enuresis in children and adolescents. | |
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MedLine Citation:
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PMID: 17727574 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Nocturnal enuresis (NE) is one of the most frequent paediatric pathologies. The prevalence of primary nocturnal enuresis (PNE) is around 9% in children between 5 and 10 years of age and about 40% of them have one or more episodes per week. Still for too long, PNE has not been recognised as a pathological condition, particularly by the medical community; as a consequence, there was no specific education at medical school, and a poor involvement by the practitioners. Enuretic children have a sense of social difference and isolation; some of them do express a low self-esteem. Also, self-esteem is improved by the management NE even if this management fails to cure the condition. Primary monosymptomatic nocturnal enuresis (PMNE) is an heterogeneous condition for which various causative factors have been identified such as: nocturnal polyuria, sleep disturbances, reduced bladder capacity or bladder dysfunction, upper airway obstruction. The positive diagnosis of PMNE is based on a complete questionnaire and a careful physical examination. A drinking and voiding chart is an essential non-invasive tool: first, to collect information about the initial drinking and voiding habits of the child, then to reassess the accuracy of the diagnosis. Only motivated patients should receive a specific treatment for their NE and the treatment should be proposed based on the type of PMNE. PMNE associated with nocturnal polyuria should be treated with desmopressin, which reduces nighttime urine production. For PMNE with a reduced bladder capacity alarms should be the first-line treatment. Oxybutinin, a drug with anticholinergic properties, is not theoretically indicated for the treatment of PMNE except for a very small subgroup of patients who have an overactive bladder only during sleep. In cases refractory to monotherapy, NE is probably the result of an association of different physiopathological factors (e.g. both a nocturnal polyuria together with a small bladder capacity) some of them are still unknown. In these patients, a combination of treatments may be more effective than monotherapy. Various combination therapies can be proposed to improve the cure rates. |
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Authors:
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H B Lottmann; I Alova |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: International journal of clinical practice. Supplement Volume: - ISSN: 1368-504X ISO Abbreviation: Int J Clin Pract Suppl Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-08-30 Completed Date: 2008-03-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9712380 Medline TA: Int J Clin Pract Suppl Country: England |
Other Details:
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Languages: eng Pagination: 8-16 Citation Subset: IM |
Affiliation:
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Paediatric Urology Unit, Service de Chirurgie Viscerale Pediatrique, Hôpital Necker-Enfants Malades, Paris, France. henrilottmann@wanadoo.fr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Antidiuretic Agents / therapeutic use Child Combined Modality Therapy Deamino Arginine Vasopressin / therapeutic use Humans Nocturnal Enuresis / epidemiology, physiopathology, therapy* |
| Chemical | |
Reg. No./Substance:
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0/Antidiuretic Agents; 16679-58-6/Deamino Arginine Vasopressin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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