Treatment System for Nocturnal
Enuresis according to an
Original Classification System

Watanabe, Hiroki; Kawauchi, Akihiro; Kitamori, Tomohito; Azuma, Yutaro

doi:10.1159/000475246

Cited by 56 publications

(22 citation statements)

References 7 publications

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“…A follow-up analysis of patients with these three patterns of nocturnal enuresis demonstrated that over time an evolution in patterns occurred: 20% of type IIb patients changed into type IIa, while 60% changed into type I, whereas 78% of type IIa patients changed into type I [21]. This evolution suggests that a dual developmental process is occurring which involves maturation of both CNS control over bladder contraction and CNS responsiveness to bladder filling and contraction.…”

Section: Cns Responses During Sleepmentioning

confidence: 96%

Cure of nocturnal enuresis: why isn’t desmopressin very effective?

Koff

1996

Pediatr Nephrol

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Prospective controlled studies on the treatment of enuresis with desmopressin (DDAVP) indicate that cure rates (complete dryness) while on therapy are markedly lower than are response rates (decrease in wet nights). In an attempt to explain this discrepancy, we analyzed the etiological mechanisms for enuresis and found evidence that most children are not cured by DDAVP because their nocturnal wetting is not actually caused by the defect which DDAVP therapy aims to cure: low nocturnal vasopressin secretion with high nocturnal urinary output. Our study suggested that an arrest in the normal development of two separate areas of the central nervous system is necessary for enuresis to occur in many patients, yet cure of enuresis occurs if either developmental delay is eliminated. This hypothesis of a dual developmental delay helps to unify many diverse and often seemingly contradictory scientific observations about this condition and to explain why many patients react inconsistently to treatment aimed at a single etiology, yet eventually become dry.

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Section: Cns Responses During Sleepmentioning

confidence: 96%

Cure of nocturnal enuresis: why isn’t desmopressin very effective?

Koff

1996

Pediatr Nephrol

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“…It has been reported that these children responded to wake up calls less than normal children, however, they could wake up after wetting the bed and there was a developmental delay in perception of bladder fullness and inhibition of bladder contractions (16). While sleeping pattern has been shown to be normal in recent studies, no answer could be given so far for why enuretics could not wake up and micturate when their bladders were full like normal children (17). In the literature, although the sleep pattern has been reported to be normal, it was observed in our study that children, who could not wake up, did not respond to treatment.…”

Section: Discussionmentioning

confidence: 97%

Motivation Therapy in Children with Primary Monosymptomatic Nocturnal Enuresis

Erol¹,

Özkuvancı²,

Yiğit³

et al. 2016

Haseki

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Abs tractAim:In the present study, socio-demographic characteristics of routinely followed primary monosymptomatic enuretic cases and the success rate of simple behavioral therapy were evaluated. Methods: Questionnaires that inquire the characteristics of enuresis were conducted on the children and their families. The children were motivated and called for regular follow-ups. Treatment success was evaluated at the end of the first, the third and the sixth months and the first year. Patients were divided into two groups as successful or unsuccessful results of treatment. Features of unsuccessful group were evaluated. Results:The total success rate was 40% at the end of the first month, 38% at the end of the third month, 50% at the end of the sixth month and 54% at the end of the first year. Nightly fluid consumption and deep sleeping problems were significantly higher in the group with no treatment success. The number of introverted patients was higher in the unsuccessful group with respect to the other group. Conclusion: Motivation therapy can be offered as a first-step treatment for children with primary monosymptomatic nocturnal enuresis, who are within the age group between six and eight can be motivated for the treatment and do not have an intense amount of bed-wetting at night.

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“…Watanabe and his colleagues, employing electroencephalography (EEG) and cystometry recording during sleep, discovered that 30-32% of a sample of children with nocturnal enuresis had uninhibited bladder contractions resulting in enuresis (18)(19)(20). Such children, perhaps not unexpectedly, had smaller functional bladder capacities at the point of wetting than children with enuresis who did not have bladder instability (21).…”

Section: Bladder Instabilitymentioning

confidence: 99%

The Three Systems: a Conceptual Way of Understanding Nocturnal Enuresis

Butler¹,

Holland²

2000

Scandinavian Journal of Urology and Nephrology

112

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Childhood nocturnal enuresis has traditionally been regarded as a multifaceted problem with a variety of treatment interventions. This paper proposes a model based on the notion that nocturnal enuresis arises through the ill functioning of one or more of the following three systems - a lack of vasopressin release during sleep; bladder instability; and/or an inability to arouse from sleep to bladder sensations. Clinical signs of each system are outlined and the appropriate treatment intervention for each is discussed. It is argued that addressing nocturnal enuresis in this way will enhance overall treatment effectiveness.

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Treatment System for Nocturnal Enuresis according to an Original Classification System

Cited by 56 publications

References 7 publications

Cure of nocturnal enuresis: why isn’t desmopressin very effective?

Cure of nocturnal enuresis: why isn’t desmopressin very effective?

Motivation Therapy in Children with Primary Monosymptomatic Nocturnal Enuresis

The Three Systems: a Conceptual Way of Understanding Nocturnal Enuresis

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