Childhood nocturnal enuresis: a problem to be solved

ABSTRACT

Nocturnal enuresis is a common problem in paediatrics which causes concern for the child, his parents, and the treating paediatrician. Although the physiopathology is not yet well understood, the most accepted theory is that there is a delay in the development of the micturation reflex, a condition with a genetic predisposition. Management includes a detailed history, a thorough physical examination, and investigations to exclude pathologic causes. Treatment is based on achieving a good communication with the child and his parents by explanation of the benign course and the high spontaneous remission rate, behavioral and conditioning therapy with the use of a buzzer alarm and the gold star chart, and finally the introduction of drugs to accelerate remission; these include imipramine, oxybutinine, and desmopressin