[Monosymptomatic nocturnal enuresis]
OBJECTIVES: Monosymptomatic nocturnal enuresis (MNE) plays a very important role in the practice of pediatrics due to its high prevalence, its psychosocial impact, and its controversial etiology and treatment. Our objective was to show that MNE can be a well-defined clinical entity (monosymptomatic), but it can also be a symptom of urinary disorder, thus requiring a completely different therapeutic approach. METHODS: The literature presents numerous publications related to the matter of MNE, thus we tried to select, for this review, the classical and the most recent publications from internationally recognized authors; in addition, we also have a 13-year work experience at the Unit for Urinary Disorders of the Pediatric Nephrology Center of the state of Paraná (Unidade de Distúrbios Miccionais - Centro de Nefrologia Pediatrica do Paraná). RESULTS: The lack of a well-defined, international consensus on the concept, terminology, and classification of MNE is an obstacle for the assessment of the numerous studies found in the literature. The individualization of the MNE clinical entity is the fundamental starting point for providing appropriate guidance for patients. Enuresis can be found in most societies and, thus, it gives way to several interpretations and forms of treatment. There is a consensus, however, on the damage to the self-esteem of enuretic children, and consequently, on the advantage of proper treatment. CONCLUSIONS: In most cases, MNE is kept as a family secret while children remain without proper guidance and treatment and suffering with the lack of understanding and damage to their self-esteem. Doctors should survey patients extensively for MNE during pediatric appointments. It is possible to discard other diagnoses with a detailed survey of habits, quality of the urination, and history of urinary infection and a meticulous physical examination. MNE should be faced as a medical problem worthy of the attention of professionals and patientś families.
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Hospital Infantil Pequeno Príncipe, Curitiba, PR, Brazil.