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

  1. 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.
  2. Kefi A, Tekgül S. Nokturnal enürezis. Türk Üroloji Dergisi 2006;32:99-105.
  3. Neyzi O, Ertuğrul T, Ekşi A. Psikososyal gelişme ve sorunlar, çocuğun ruhsal gelişimi, Enürezis, Pediatri. İstanbul: Nobel Tıp Kitabevleri, 2002;1420-1.
  4. Bodur Ş, Soysal Ş. Enurezis nokturna: Yalnızca bir tuvalet eğitimi sorunu mu? Sürekli Tıp Eğitimi Dergisi 2005;14:165-8.
  5. 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.
  6. Ergüven M, Çelik Y, Deveci M, Yıldız N. Primer enürezis nokturnada etiyolojik risk faktörleri. Türk Pediatri Arşivi 2004;39:83-7.
  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.
  8. Neveus T, Lackgren G, Tuvemo T, Hetta J, Hjälmås K, Stenberg A. Enuresis-background and treatment. Scand J Urol Nephrol 2000;206:1-44.
  9. 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.
  10. 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.
  11. Robson WLM, Leung AK. Urotherapy recommendations for bed wetting. J Nati Med Assoc 2002;94:577-80.
  12. 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.
  13. Monge ZM, Mendez AM, Garcia NV. Effectiveness of behavior and intervention in nocturnal enuresis. An Pediatr (Barc) 2005;63:444- 7.
  14. Wille S. Comparison of desmopressin and enuresis alarm for nocturnal enuresis. Arch Dis Child 1986;61:30-3.
  15. 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.
  16. 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.
  17. Aladjem M, Wohl R, Boichis H, Orda S, Lotan D, Freedman S. Desmopressin in nocturnal enuresis. Arch Dis Child 1982;57:137- 40.
  18. 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.
  19. Hourihane J, Salisbury AS. Use caution in prescribing desmopressin for nocturnal enuresis (letter: comment). Br Med J 1993; 306:1545.
  20. 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.

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How to cite

1.
Katı B, Polat EC, Kurt HA, Gümüş K. Evaluation of Patients with a Symptom of Primary Nocturnal Enuresis in the State of Sanliurfa. Turk J Pediatr Dis [Internet]. 2017 Dec. 1 [cited 2025 May 24];11(4):239-42. Available from: https://turkjpediatrdis.org/article/view/424