ABSTRACT
【Objective】 To investigate the possibility of using voiding diary (VD) to predict desmopressin diacetate arginine vasopressin (DDAVP) and enuresis alarm (EA) in the treatment of primary monosymptomatic nocturnal enuresis (PMNE). 【Methods】 A total of 100 children (aged 6 to 14 years) with PMNE treated during Jan.2018 and Oct.2022 were involved. Bladder type was classified with two-week VD. Pseudo-randomization was performed using the Danish REDCap system to group patients into the randomized group and VD group. All patients were treated for 8 weeks. 【Results】 A total of 82 cases met the inclusive criteria. The effective rate was 82.50% (33/40) and 59.52% (25/42) in the VD and randomized groups, respectively, with significant difference (χ2=5.224, P=0.022). In the randomized group, if VD was not considered, the effective rate in the DDAVP and EA subgroups was 81.82% (18/22) and 25.00% (5/20), respectively, with significant difference (χ2=13.625, P=0.000). 【Conclusion】 VD can predict the therapeutic effects of PMNE. It is necessary to record VD for two weeks before selecting appropriate treatment methods. For patients who choose treatment without reference to VD, DDAVP shows better response than EA, but the recurrence rate after discontinuation of treatment requires further follow-up.
ABSTRACT
OBJECTIVE: To explore the effectiveness of enuresis alarm therapy on preschool children with primary monosymptomaticnocturnal enuresis(PMNE). METHODS: Totally 95 PMNE preschool children aged 3.5 to 6 years admitted between January 2017 and July 2018 to Department of Nephrology,Affiliated Children's Hospital of Capital Institute of Pediatrics,were randomly divided into two groups:alarm group(53 cases)and control group(42 cases). The alarm group was managed by enuresis alarm therapy,while the control group received basic treatment. Treatment ceased after 12 weeks of training or when the cases achieved 14 consecutive dry nights(meaning successful treatment). The relapse cases were recorded 1 month after stopping treatment. The alarmtherapy was performed again in the relapse cases for another course. RESULTS: Seven cases(13.2%)discontinued intervention in the alarm group. The response of the alarm therapy in the remaining 46 patients was as follows:full response(FR)in 29 cases(63.0%),partial response(PR)in 7 cases(15.2%),no response(NR)in 10 cases(21.7%). A total of 25 patients achieved 14 consecutive dry nights in FR cases. Successful treatment requires a minimum course of treatment for 42 days. Relapse occurred in 11 cases within the first 1 month after stopping treatment,and 8 relapse patients responded to another course of alarm therapy. Three cases(7.1%)lost to follow-up in the control group. The response of the control group in the remaining 39 patients was as follows:FR in 0 case,PR in 17 cases(43.6%)and NR in 22 cases(56.4%). No cases achieved successful treatment in the control group. The full response rate was significantly different between two groups(Fisher's exact test χ~2=55.10,P=0.00). Half(5 cases)of NR patients were less than 4 years old,while in the FR+PR patients,the percentage of children under 4 years old was only 8.3%(3 cases)in alarm therapy group(Pearson chi-square test,χ~2=9.457,P=0.007). No severe adverse events occurred in all cases. CONCLUSION: Enuresis alarm therapy is a safe and effective way to treat PMNE preschool children. The enuresis alarm provided gradual effects and require more than 1 month in achieving successful effect. The appropriate age for alarm treatment is over four years old.
ABSTRACT
Behavioral therapy refers to a broad range of treatment modalities that regulate the child's behavior to induce a therapeutic effect on nocturnal enuresis. Simple behavioral therapies include fluid restriction, lifting, waking, introducing reward systems, and bladder training. Simple behavioral therapy is significantly less effective than an enuresis alarm or desmopressin. If a child needs treatment, an enuresis alarm or desmopressin should not be delayed. Enuresis alarms are an effective form of treatment, although they require active involvement of the health care provider to reduce the likelihood of dropout and to motivate the child and parents.
Subject(s)
Child , Humans , Behavior Therapy , Deamino Arginine Vasopressin , Enuresis , Health Personnel , Lifting , Nocturnal Enuresis , Parents , Reward , Urinary BladderABSTRACT
ObjectiveTo investigate the efifcacy of alarm treatment in a sample of China monosymptomatic nocturnal enuresis (MNE) children and adolescents with smaller than expected bladder capacity (EBC) for age.Methods Fifteen MNE pa-tients with a smaller than age-expected BC and without nocturia were included. All the patients were treated with enuretic alarm and water restriction 2 hours before sleep. All patients were followed up monthly. A success criterion was deifned as “14 con-secutive dry nights” after successive 2-3 months treatment. A relapse criterion was deifned as “more than two wet nights every two weeks” after therapy discontinuation. The relapsed patients were treated with enuretic alarm and followed up again.Results The patients consisted of 9 boys and 6 girls. The mean age was 9.76±4.24 years (6-15 years). Thirteen patients were successfully cured after three months treatment. Two patients discontinued the treatment and received the treatment of desmopressin. Five patients relapsed and received the enuresis alarm treatment again. Four patients had never relapsed, and one failed. The cure rate was 80%.Conclusions The enuretic alarm device is effective on MNE patients with a smaller than age-expected BC and without nocturia.