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

Abstract

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.

Prevalence, Risk Factors, and Psychological Effects of Primary Nocturnal Enuresis in Chinese Young Adults

“…Many people who experience PNE continue bedwetting when they grow up with no clear reason although it has been known that many factors contribute to this abnormality. With social and economic development, there is an increasing need to further understand and prevent PNE in adults [20].…”

Nocturnal Enuresis: A Review and Focus on The Treatment Modalities of Monosymptomatic Nocturnal Enuresis

“…Moreover, the history of distinguishing between primary and secondary enuresis is also vital because secondary enuresis is often associated with stress and psychological problems. 30,31 Physical examination should be performed, emphasizing the spinal, neurologic, and genital examinations to exclude other diseases that cause urinary incontinence, such as spinal cord abnormalities and genitourinary tract abnormalities (e.g., ectopic ureter, partial labial fusion). Examination for constipation is also crucial because constipation is frequently related to wetting.…”

Attention Deficit and Hyperactivity Disorder and Enuresis co-occurrence in the pediatric population: a systematic review and meta-analysis

“…Primary enuresis occurs when individuals have never been able to control micturition or have a previous dry period less than six months (Nevéus et al, 2020). Primary enuresis seems to have a genetic component, the incidence of enuresis is about 15% if none of the parents or their immediate relatives suffered from enuresis, about 44%, if one of the parents or their immediate relatives suffered from enuresis and can be up to 77% if both parents have a positive story (Bogaert et al, 2020; Butler et al, 2005). Secondary enuresis refers to children who have previously experienced at least six months of dryness, but who have experienced relapses.…”