title: [Further development of 'Enuresis nocturna' guidelines for children with persistent problems].
abstract: To achieve dryness in children who suffer from persistent bedwetting, it is important to find out which factors play a role in their bedwetting and why previous treatment has failed. The use of a micturition diary is essential. The child's problems and needs have to be identified and treated individually. The enuresis alarm, with the proper guidance, is the preferred form of initial treatment. Desmopressin is particularly suitable in cases of nocturnal polyuria or if the use of the alarm is unfeasible. If the alarm does not have any effect within two weeks or if a rapid result is important, a combination of desmopressin and the alarm is advisable. Bedwetting combined with daytime micturition problems is often indicative of a small bladder capacity and/or detrusor instability. In these children bladder training and/or treatment with an anticholinergic drug (possibly combined with desmopressin) may be effective.
authors.forename: R A
authors.initials: RA
authors.lastname: Hira Sing
authors.forename: F J
authors.initials: FJ
authors.lastname: van Leerdam
authors.forename: R N
authors.initials: RN
authors.lastname: Sukhai
authors.forename: J W
authors.initials: JW
authors.lastname: van Capelle
authors.forename: F M
authors.initials: FM
authors.lastname: Froeling
authors.forename: M A
authors.initials: MA
authors.lastname: Vijverberg
mesh_terms: D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D004775:Enuresis / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D012076:Renal Agents / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D012076:Renal Agents; D003894:Deamino Arginine Vasopressin