Abstract
Objective: Evaluation of our primary nocturnal enuresis patients’ profile and their treatment outcome.
Material and Methods: We included 324 of the 540 patients aged over 5 years who had applied to our outpatients between January 2013 and January 2016 and were treated for primary nocturnal enuresis. Fifty-six patients who had not received relevant information before were treated for one month with behavioral and motivational therapy. A total of 324 patients who did not benefit from this behavioral and motivational therapy or who showed relapse were started on desmopressin at a dose of 60-120 micrograms. “Full response” was defined as a decrease of 90-100% in the number of wetting instances, “moderate response” as a decrease of 50-90%, and “failed response” as a decrease of less than 50%. Treatment and relapse rates were evaluated based on the response to therapy at the time of follow-up. results: The mean age was 10.57±2.37 (minimum 5 maximum 18) years, except the 8 patients who were treated with behavioral and motivational therapy and had no relapse. Full dryness was provided in 166 (51.2%) of the patients who did not have benefit from the behavioral and motivational therapy by itself and used 120 micrograms Desmopressin. “Moderate response” was obtained in 107 (33.3%) patients. “Failed response” was obtained in 51 (15.5%) patients. Relapse was seen in case of discontinuing Desmopressin in 45 (27.1%) patients who had benefited from Desmopressin. Treatment could not proceed in 4 patients who did not respond because of headache and allergy
Keywords: Behavior therapy, Desmopressin, Nocturnal enuresis, Motivation
References
- Haque M, Ellerstein NS, Grundy JH, Shelov SP, Weiss JC, McIntire MS, et al. Parental perceptions of enuresis: A collaborative study. Am J Dis Child 1981;135:809-11.
- Kefi A, Tekgül S. Nokturnal enürezis. Türk Üroloji Dergisi 2006;32:99-105.
- Neyzi O, Ertuğrul T, Ekşi A. Psikososyal gelişme ve sorunlar, çocuğun ruhsal gelişimi, Enürezis, Pediatri. İstanbul: Nobel Tıp Kitabevleri, 2002;1420-1.
- Bodur Ş, Soysal Ş. Enurezis nokturna: Yalnızca bir tuvalet eğitimi sorunu mu? Sürekli Tıp Eğitimi Dergisi 2005;14:165-8.
- Safarinejad MR. Prevalence of nocturnal enuresis, risk factors, associated familial factors and urinary pathology among school children in Iran. J Pediatr Urol 2007;3:443-52.
- Ergüven M, Çelik Y, Deveci M, Yıldız N. Primer enürezis nokturnada etiyolojik risk faktörleri. Türk Pediatri Arşivi 2004;39:83-7.
- Oğraş MS. Elazığ ilinde enürezis nokturnalı erkek çocuklarda ailelerin tedavi ile ilgili yanlış inanışları ve düzelme beklentileri. Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi 2010;24:155-9.
- Neveus T, Lackgren G, Tuvemo T, Hetta J, Hjälmås K, Stenberg A. Enuresis-background and treatment. Scand J Urol Nephrol 2000;206:1-44.
- Skoog SJ, Scherz HC. Office pediatric urology. In: Gillenwater JY, et al, (eds). Adult and Pediatric Urology, 4th ed. Phila delphia: LWW 2002;2671-2717.
- Çarman KB, Nuhoğlu Ç, Ceran Ö. İstanbul ili Ümraniye İlçesi’nde bir grup okul çocuğunda enürezis nokturna prevalansı. Türk Pediatri Arşivi 2003;38:153-9.
- Robson WLM, Leung AK. Urotherapy recommendations for bed wetting. J Nati Med Assoc 2002;94:577-80.
- Soker M, Cakmak A, Haspolat K ve ark. Komplike ol mayan primer mono semptomatik enürezis nokturnada davranış terapisi ve intranasal desmopressin tedavisinin değerlendirilmesi. Ege Tıp Dergisi 1999;38:137-43.
- Monge ZM, Mendez AM, Garcia NV. Effectiveness of behavior and intervention in nocturnal enuresis. An Pediatr (Barc) 2005;63:444- 7.
- Wille S. Comparison of desmopressin and enuresis alarm for nocturnal enuresis. Arch Dis Child 1986;61:30-3.
- Örmeci AR, İstanbullu B, Çomak E, Altın H. Primer enü rezis nokturna tedavisinde davranış, alarm yatağı ve des mopressin tedavilerinin etkilerinin karşılaştırılması. Çocuk Dergisi 2003;3:119- 23.
- WE Kaplan, Incontinence. In: P Abrams, S Khoury, A Wein, editors. Conservative management in children: Non-neuropathic bladder-sphincter dysfunction and neuropathic bladder-sphincter dysfunction. 1st ed. Plymouth: Health Publications,1998; 522-46.
- Aladjem M, Wohl R, Boichis H, Orda S, Lotan D, Freedman S. Desmopressin in nocturnal enuresis. Arch Dis Child 1982;57:137- 40.
- Guillaud R, Amram S, Lememme F, Lesbros D. Desmopressin and water intoxication. A propose of a case treated for enuresis. Pediatrie 1993;48:697-9.
- Hourihane J, Salisbury AS. Use caution in prescribing desmopressin for nocturnal enuresis (letter: comment). Br Med J 1993; 306:1545.
- Schwab M, Wenzel D, Ruder H. Hyponatraemia and cerebral convulsion due to short term DDAVP therapy for control of enuresis nocturna. Eur J Pediatr 199;155:46-8.
Copyright and license
Copyright © 2017 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.