Abstract

Objective: Monosymptomatic nocturnal enuresis may cause psychological and behavioral problems in children and is an important problem that affects the family adversely. The etiology of monosymptomatic nocturnal enuresis is not clear but there are various reasons described. These factors are low functional bladder capacity, excess urine production at night and inadequate waking up at night. A variety of therapeutic methods have been tried for these factors. The primary behavioral therapy methods, an alarm, medical treatment, hypnosis and acupuncture are the main treatment modalities. Acupuncture is applied with a needle, electric current or laser light. Laser acupuncture is a painless, noninvasive and inexpensive treatment modality. Various success rates have been reported for acupuncture treatment of MNE in the literature. The aim of our study was to evaluate the effect of laser acupuncture treatment on MNE Material and Methods: 20 patients who presented to the Pediatric Surgery Clinic with nocturnal enuresis complaints and accepted the

laser acupuncture treatment protocol were enrolled in the study. Before starting treatment, all patients underwent physical examination.

Voiding diaries, symptom scores, uroflowmetry, urinary tract ultrasonography and urine cultures were evaluated. During the treatment

period, all cases were followed by rain-solar calendars. Laser acupuncture treatment was administered for a minute to each point in the

cases included in the study, three times a week for a period of 4 weeks. Behavioral therapy was used for all parents and these treatment

modalities were controlled regularly. After the end of the treatment all patients were recalled at the 1st and 3rd months. The voiding diary

and symptoms score were reevaluated at the end of the third month.

Results: 10 patients were male, while 10 were female (mean age: 9.4 +2.5 years). Before starting treatment, the mean functional bladder

capacity in the voiding diary was 172.5±59.02 ml. The mean symptom score was 14.30±4.11. First month after treatment, follow-up

mean functional bladder capacity had increased to 220.79±65.33 ml, and the mean symptom scores had decreased to 2.95±2.17. The

third month after treatment, the night accident number was 1.47±1.17 days per month.

Conclusion: 3 months after the end of treatment, complete cure was achieved in 26.3% of the patients who were followed up for primary

nocturnal enuresis. The complaints progressively decreased in 73.6% of cases. After treatment, a 48.29 ml increase in mean functional

bladder capacity was observed. We suggest application of laser acupuncture for monosymptomatic nocturnal enuresis as an alternative

treatment modality.

Keywords: Acupuncture, Child, Enuresis

References

  1. Neveus T, Eggert P, Evans J, Macedo A, Rittig SS, Tekgül J, et al. Evaluation of and treatment for monosymptomatic enuresis: A standardization document from the International Children’s Continence Society. J Urol 2010;183;441-7.
  2. Avanoğlu A, Baskın E, Söylemezoğlu O, Tekgül S, Ziylan O, Zorludemir Ü. Türkiye enürezis çalışma grubu. Türkiye Enürezis Tedavi Kılavuzu, Aralık 2010 (http://www.peduro.org.tr/docs/tek. pdf).
  3. Nogaard JP, Pedersen EB, Djurhuus JC. Diurnal anti-diuretic- hormone levels in enuretics. J Urol 1985;134:1029-31.
  4. Watanabe H, Azuma Y. A proposal for a classification system of enuresis based on overnight simultaneous monitoring of electroencephalography and cystometry. Sleep 1989;12:257-64.
  5. Djurhuus JC. Definitions of subtypes of enuresis. Scand J Urol Nephrol 1999;202:5-7.
  6. Neveus T, Tuvemo T, Lackgren G, Stenberg A. Bladder capacity and renal concentrating ability in enuresis: Pathogenic implications. J Urol 2001;165:2022-25.
  7. Rasmussen PV, Kirk J, Borup K, Norgaard JP, Djurhuus JC. Enuresis nocturna can be provoked in normal healthy children by increasing the nocturnal urine output. Scand J Urol Nephrol 1996;30:57-61.
  8. Cai W. Acupuncture and the nervous system. Am J Chin Med 1992;20:331-7.
  9. Fu H. What is the material base of acupuncture? The nerves Med Hypotheses 2000; 54: 358-59.
  10. Zhao L, Wang Y, Sun N, Liu X, Li L, Shi J. Electroacupuncture regulates TRPM7 expression through the trkA/ PI3K pathway after cerebral ischemia-reperfusion in rats. Life Sci 2007;81:1211-22.
  11. Manni L, Albanesi M, Guaragna M, Barbaro Paparo S, Aloe L. Neurotrophins and acupuncture. Auton Neurosci 2010;157:9-17.
  12. Bucinskaite V, Lundeberg T, Stenfors C, Ekblom A, Dahlin L, Theodorsson E. Effects of electro-acupuncture and physical exercise on regional concentrations of neuropeptides in rat brain. Brain Res 1994;666:128-32.
  13. Minni B, Capozza N, Creti G, De Gennaro M, Caione P, Bischko J. Bladder instability and enuresis treated by acupuncture and electro-therapeutics: Early urodynamic observations. Acupunct Electrother Res 1990;15:19-25.
  14. Chinese Acupuncture and Moxibustion. Cheng Youbang (ed). Foreign Languages Press Beijing, 1987;408-9.
  15. Biol 1995;41:161-70.
  16. Bjorkstrom G, Hellstrom AL, Andersson S. Electro-acupuncture in the treatment of children with monosymptomatic nocturnal enuresis. Scand J Urol Nephrol 2000;34:21-6.

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How to cite

1.
Özmert S, Öztürk F, Tiryaki T. Nocturnal Enuresis Laser Acupuncture Treatment in Patients with Monosymptomatic. Turk J Pediatr Dis [Internet]. 2015 Jun. 1 [cited 2025 May 25];9(2):113-8. Available from: https://turkjpediatrdis.org/article/view/335