A comprehensive review of adult enuresis

Akhavizadegan, Hamed; Locke, Jennifer A.; Stothers, Lynn; Kavanagh, Alex

doi:10.5489/cuaj.5485

Cited by 24 publications

(26 citation statements)

References 27 publications

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“…[4,5]. Although insufficient arousal mechanisms during sleep are an essential part of NE, NE may be caused by multifactorial aetiologies, such as LUT dysfunctions, neurogenic diseases, psychiatric medications, and sleep disorders just to name a few [6]. Apart from the lack of attention and available research data, published studies have focussed on either clinical symptoms or urodynamic characteristics, without providing comprehensive evaluations on quantified symptoms, bladder function, and comorbid conditions.…”

Section: Discussionmentioning

confidence: 99%

“…A thorough clinical history was taken to confidently distinguish NE from other causes of nocturnal UI. We used the following criteria when recruiting our patients: (i) the complain of unintended voiding during night‐time sleep (in other words, the bedwetting occurs due to patients failing to wake up to void); (ii) NE occurring at least once per week; (iii) and with a symptom duration of ≥3 months [1,6,10]. Urine analysis was done to exclude concurrent UTI, and physical examination was performed to exclude palpable mass, potential malignancies, and anatomical abnormalities of the urinary tract.…”

Section: Methodsmentioning

confidence: 99%

“…In adults, NE is associated with multiple risk factors and has significant negative impacts on quality of life (QoL) [5]. NE can be either primary, which is further stratified into persistent (never dry for >6 months) and recurrent (dry for > 6 months before adulthood recurrence) subtypes based on symptom continuity; or secondary to lower urinary tract (LUT) dysfunctions, neurogenic conditions, psychiatric disorders, sleep apnoea, metabolic disturbance, and certain medication consumption [6–8]. Although studies have investigated the symptoms and urodynamic features of NE in adults, some key evaluation outcomes have been missing, and in particular, the bladder diary, which is a useful method in assessing LUTS, as recommended by the guidelines [9].…”

Section: Introductionmentioning

confidence: 99%

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The clinical features and predictive factors of nocturnal enuresis in adult men

et al. 2020

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To characterise the clinical features and to discover predictive factors of adult males with nocturnal enuresis (NE). Patients and Methods A total of 43 eligible adult male patients (mean age was 57.8 years) were recruited prospectively over a 2-year period. After documentation of medical history, lower urinary tract symptoms (LUTS) were assessed using the International Consultation on Incontinence Modular Questionnaire-male LUTS (ICIQ-MLUTS), and a 3-day ICIQ-bladder diary (ICIQ-BD). Videourodynamic studies (VUDS) were conducted conforming to the International Continence Society standards. Univariate and multivariate linear regressions were performed to determine potential predictive factors. Results Patients with NE had a variety of LUTS and had a high incidence of obesity and comorbidities. On the ICIQ-BD, NE was associated with nocturnal polyuria (NP), reduced nocturnal bladder capacity (NBC), or a combination of both. Subgroup analysis indicated that patients with more frequent NE had: higher body mass index (BMI); more comorbidities; reduced daytime urinary frequency and urgency quality of life (QoL) sub-scores; and increased stress urinary incontinence (SUI) and nocturnal bedwetting sub-scores. Patients with reduced NBC only, had fewer NE episodes, while patients with NP, or with both NP and reduced NBC were more likely have frequent NE. Multivariate analysis confirmed that: BMI; neurogenic causes; sub-scores of SUI QoL and bedwetting domain; the presence of reduced NBC, and both NP and reduced NBC; and bladder outlet obstruction, were all independent predictive factors for the severity of NE. Conclusions NE n the adult male should be systemically assessed and treated, as obesity, neurogenic disorders, excessive urine production, bladder storage and emptying dysfunctions are risk factors. Bladder diaries and VUDS provide valuable information on potential pathophysiological causes, which could assist clinical evaluation and selection of focussed treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The clinical features and predictive factors of nocturnal enuresis in adult men

et al. 2020

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“…It should be explained that in the event of behavioral or psychiatric problems, the success rate will be lower and the relapse rate higher so that the child and their family have realistic expectations of the treatment . Adolescents and young adults with NE have a higher incidence of anxiety, depression, chronic fatigue, and lower self‐esteem . It is unknown if these conditions result from NE or make it worse.…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

“…2 Adolescents and young adults with NE have a higher incidence of anxiety, depression, chronic fatigue, and lower self-esteem. 23 It is unknown if these conditions result from NE or make it worse.…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

Practical recommendations of the EAU‐ESPU guidelines committee for monosymptomatic enuresis—Bedwetting

Bogaert

Stein

Undre

et al. 2019

Neurourology and Urodynamics

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Background and Aims: The objective of this update of the EAU-ESPU guidelines recommendations for nocturnal enuresis was to review the recent published literature of studies, reviews, guidelines regarding the etiology, diagnosis and treatment options of nocturnal enuresis and transform the information into a practical recommendation strategy for the general practitioner, pediatrician, pediatric urologist and urologist. Material and Methods: Since 2012 a monthly literature search using Scopus® was performed and the relevant literature was reviewed and prospectively registered on the European Urology bedwetting enuresis resource center (http:// bedwetting.europeanurology.com/). In addition, guideline papers and statements of the European Society for Paediatric Urology (ESPU), the European Association of Urology (EAU), the National Institute for Health and Care Excellence (NICE) and the International Children Continence Society (ICCS) were used to update the knowledge and evidence resulting in this practical recommendation strategy.Recommendations have been discussed and agreed within the working group of the EAU-ESPU guidelines committee members. Results:The recommendations focus to place the child and his family in a control position. Pragmatic analysis is made of the bedwetting problem by collecting voiding and drinking habits during the day, measuring nighttime urine production and identification of possible risk factors such as high-volume evening drinking, nighttime overactive bladder, behavioral or psychological problems or sleep disordered breathing. A questionnaire will help to identify those risk factors. Conclusion: Motivation of the child is important for success. Continuous involvement of the child and the family in the treatment will improve treatment compliance, success and patient satisfaction.bedwetting, guidelines, monosymptomatic enuresis, practical recommendations Abbreviations: EAU, the European Association of Urology; ESPU, European Society for Paediatric Urology; UTI, urinary tract infections.

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The relative importance of different consequences of nocturnal enuresis among older women: A conjoint analysis experiment

Welk

Kennelly

2022

Neurourology and Urodynamics

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Introduction: Adult nocturnal enuresis (NE) is an understudied and bothersome condition. Our objective was to conduct a conjoint analysis experiment to better understand the relative importance of NE consequences in older women. Methods:We developed a conjoint analysis survey that included four attributes related to NE (awakening at night, feeling rested in the morning, restricting fluid before bed, and wet perineal skin). We performed a prospective cross-sectional online study of women >62 years of age with NE using Sawtooth Software. Patients completed baseline questions, the International Consultation on Incontinence Questionnaire-nocturia Quality of Life (ICIQ-NqoL), and the conjoint analysis experiment. Hierarchical Bayes random effects regression analysis was used to determine the relative importance of the four attributes.Results: A total of 200 women with a mean age of 71 years completed the study. The most common management of NE was diapers/pads (132/200). Approximately half of the participants experienced NE several times a week or nightly (101/200). The most important attribute was the frequency of being awakened at night (34, standard deviation [SD]: 16) and the frequency of feeling rested in the morning (32, SD: 15). Limiting drinking before bed (18, SD: 12) and wet groin skin (16, SD: 10) had significantly lower importance scores (p < 0.05). Age, sleeping with a partner in bed, body mass index, NE severity score, and the ICIQ-NqOL score were not significantly associated with any of the importance scores.Conclusions: Older women with NE place significantly more importance on the frequency of awakening at night, and feeling rested in the morning and lesser importance on associated lifestyle or physical manifestations of NE.

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A comprehensive review of adult enuresis

Cited by 24 publications

References 27 publications

The clinical features and predictive factors of nocturnal enuresis in adult men

The clinical features and predictive factors of nocturnal enuresis in adult men

Practical recommendations of the EAU‐ESPU guidelines committee for monosymptomatic enuresis—Bedwetting

The relative importance of different consequences of nocturnal enuresis among older women: A conjoint analysis experiment

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