Enurese noturna monossintomática

Abstract

Objective: to analyze the clinical history and evolution of children and adolescents with IH, emphasizing some of their peculiar features. Methods: we followed 471 patients with IH at an outpatient clinic. Patients were submitted to the following protocol: abdominal X-ray, kidney and urinary tract ultrasonography; urinary ionogram, blood gas and biochemical analyses; 24-hour urine for measurement of calcium and other electrolytes and creatinine; urinalysis, urine culture and phase-contrast microscopy; second morning urine collected after fasting for measurement of calcium and creatinine. Results: at the time of diagnosis, 6% of the patients were infants, 15% preschool children, 55% school children, and 24% adolescents ; 56% of them were boys. Clinical and laboratory findings were: 47% had hematuria and abdominal pain, 31% had isolated hema-turia, 14% isolated abdominal pain, and 8% had urinary tract infection, nocturnal enuresis, suprapubic pain or urethralgia, or the frequency/urgency syndrome with urinary incontinence. Hypercalciuria was associated with urolithiasis in 56% of patients. There was association with hyperuricosuria in 18.5% of the cases, and hypocitraturia in 8.5% of the cases. Evolution was poor for 33% of the patients, with recurrence of nephrolithiasis, persistence of hematuria, and abdominal pain. Conclusions: IH must be diagnosed and treated with criteria in order to reduce consequences such as hematuria, abdominal pain, urinary stone formation and possible bone involvement. Signs and symptoms such as urgency and urinary incontinence, suprapubic pain and nocturnal enuresis may result from renal hyperexcretion of calcium. J Pediatr (Rio J) 2001; 77 (2): 101-4: hematuria, enuresis, urinary incontinence. Resumo Objetivo: analisar a história clínica e evolução de crianças e adolescentes com HI, ressaltando peculiaridades próprias destes pacientes. Métodos: 471 pacientes portadores de HI têm sido acompanha-dos em regime ambulatorial, sendo submetidos ao protocolo: Rx de abdome, ultra-sonografia de rins e vias urinárias; ionograma, gaso-metria e bioquímica de sangue; urina de 24 horas para dosagem de cálcio e outros eletrólitos e creatinina; urinálise, urocultura e micros-copia de contraste de fase; urina de segunda micção matinal em jejum para dosagem de cálcio e creatinina. Resultados: 56% masculinos e 44% femininos; 56% brancos, 37% não-brancos e 7% sem relato da cor da pele. Ao diagnóstico 6% eram lactentes, 15% pré-escolares, 55% escolares e 24% adolescen-tes. 47% tinha hematúria associada à dor abdominal, 31% hematúria isolada, 14% dor abdominal isolada, e 8% tinham infecção urinária, enurese noturna, dor suprapúbica ou uretral ou a síndrome miccional com freqüência/urgência e incontinência urinária. A associação de hipercalciúria com litíase do trato urinário foi positiva em 56% dos pacientes. Em 18,5% houve associação com hiperuricosúria e em 8,5% com hipocitratúria. 33% dos pacientes tiveram má evolução com recorrência de nefrolitíase, persistência de hematúria e dor abdominal. Conclusões:...

Assessment of domestic violence against children and adolescents with enuresis

“…Para os pais e educadores dessas crianças, a enurese é uma das mais frustrantes doenças da infância, podendo levar a um sentimento familiar de ansiedade, culpa, dificuldades de relacionamento, perda da confiança e autoestima 10 . Dentre os fatores de estresse familiar encontram-se a elevação de despesas, tempo e esforços associados com a limpeza e compra de novas roupas pessoais e roupas de cama, bem como de colchões, travesseiros e sofás 11 .…”

Nocturnal Enuresis: A Synopsis of Behavioral and Pharmacological Management

“…One more study said that the cure rates for enuresis of night alarm is two thirds, and its relative risk of failure rate is 38% (Glazener Cathryn MA, et al 2005). The night urine alarm device is based on the behavioral therapy technique and it make an effort to wake up the child when the bladder is full (Meneses R, 2001). Even though it is gold standard therapy the treatment effect and response rate of night alarm are not immediate and treatment should be continued for 2-3 months or until the child is dry for 14 consecutive nights.…”

Avaliação da violência intradomiciliar na criança e no adolescente enuréticos

“…9 These children's parents and teachers consider enuresis one of the most frustrating childhood disorders, causing feelings of anxiety and guilt, relationship difficulties, loss of trust and self-esteem among the family members. 10 Higher expenses, longer time and more effort associated with cleaning and purchase of new clothes and bed linen, as well as mattresses, pillows and couches are among the stressing factors for family members. 11 Punishment due to urinary incontinence can compromise the treatment, generating lack of self-confidence and reducing self-esteem in children and adolescents.…”