title: Medical management of nocturnal enuresis.
abstract: Nocturnal enuresis, or bedwetting, is the most common cause of urinary incontinence in children. It is known to have a significant psychosocial impact on the child as well as the family. Nocturnal enuresis typically presents as failure to become dry at night after successful daytime toilet training. It can be primary or secondary (developing after being successfully dry at night for at least 6 months). Children with nocturnal enuresis may have excessive nocturnal urine production, poor sleep arousal and/or reduced bladder capacity. Alarm therapy is the recommended first-line therapy, with treatment choices being influenced by the presence or absence of the abnormalities mentioned above. Children with nocturnal enuresis may also have daytime urinary urgency, frequency or incontinence of urine. This group (non-monosymptomatic nocturnal enuresis) requires a different clinical approach, with a focus on treating daytime bladder symptoms, which commonly involves pharmacotherapy with anticholinergic medications and urotherapy (including addressing bowel problems). This review discusses the current management of nocturnal enuresis using the terminologies recommended by the International Children's Continence Society.
authors.affiliation: Department of Urology, The Childrens Hospital at Westmead, Westmead, NSW, Australia.
authors.forename: Aniruddh V
authors.initials: AV
authors.lastname: Deshpande
authors.forename: Patrina H Y
authors.initials: PH
authors.lastname: Caldwell
mesh_terms: D000465:Algorithms; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D050034:Antidiuretic Agents / Q000627:therapeutic use*; D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use; D008333:Mandelic Acids / Q000627:therapeutic use; D009481:Neurophysins / Q000819:agonists; D053206:Nocturnal Enuresis / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D011498:Protein Precursors / Q000819:agonists; D012307:Risk Factors; D014667:Vasopressins / Q000819:agonists
chemical_list: C438657:AVP protein, human; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000929:Antidepressive Agents, Tricyclic; D050034:Antidiuretic Agents; D018680:Cholinergic Antagonists; D008333:Mandelic Acids; D009481:Neurophysins; D011498:Protein Precursors; D014667:Vasopressins; D003894:Deamino Arginine Vasopressin; C005419:oxybutynin; D007099:Imipramine