[Nocturnal enuresis in children--how to diagnose, how to treat?]. / Moczenie nocne u dzieci--jak diagnozowac, jak leczyc?

The aim of this article is to review International Children's Continence Society guidelines on the recommended diagnostic evaluation and therapy for children with nocturnal enuresis. Nocturnal enuresis (NE) is the condition describing the symptom of wetting during sleep above the age of 5 years. NE is one of the most common disorders among children. Enuresis is characterised as monosymptomatic nocturnal enuresis (MNE) if there are no additional voiding problems. Children with other daytime symptoms (daytime incontinence, urgency, frequency) and nocturnal enuresis are said to have non-monosymptomatic nocturnal enuresis (NMNE). A careful medical history, including bladder diary, physical examination, urinalysis, an ultrasound of the urinary tract system will usually provide sufficient information for the physician to arrive at a diagnosis. Urodynamic, radiologic and endoscopic evaluation are not necessary in children with monosymptomatic nocturnal enuresis. Two first line treatment options of MNE are currently recommended: nonpharmacologic treatment and pharmacologic treatment (desmopressin). Nonpharmacologic treatment of enuresis includes motivational therapy, bladder-training exercises, fluid and food intake and enuresis alarm. Before using alarm treatment or desmopressin, simple therapeutic interventions should be considered. Children with nocturnal poliuria and normal bladder capacity will be more sensitive to desmopressin.

[Defects of the low urinary tract as a cause of recurrent urinary tract infection in girls]. / Wady dolnych dróg moczowych jako przyczyna nawracajacych zakazen ukladu moczowego u dziewczat.

462 girls aged 1 month--15 years with recurrent urinary tract infection were diagnosed in the Outpatient Clinic of Mother and Child Institute during 1985-1992 and 1999-2000 years period. The most common cause of recurrent urinary tract infection was an isolated construction of external urethral ostium--59.9% (187/312) then vesico-ureteral reflux coexisting with external urethral ostium--41.1% (125/312), next isolate vesico-ureteral reflux--22.5% (104/462). Typical radiological diagnostic was performed in all cases and calibration of urethrae was 416 girls. From 75% (312/416) cases with urethral construction only 54.7% (253/462) had typical cystographic picture of that defect. Results of our studies confirmed the importance of exact diagnosis of "lower part of urinary tract" and necessity of appropriate treatment.

[Usefulness of Uro-Vaxom in complex treatment of recurrent urinary tract infections in girls]. / Przydatnosc preparatu Uro-Vaxom w kompleksowym leczeniu nawracajacych zakazen ukladu moczowego u dziewczat.

Uro-Vaxom was used in the treatment of recurrent urinary tract infections in 35 girls. Most of them (34/35) tolerated the drug very well, no side effect were observed. We stopped administration of the Uro-Vaxom in one girl, during the first month of treatment because of vomiting. This way efficiency of Uro-Vaxom was evaluated in the treatment of recurrent urinary tract infections in 34 girls. Uro-Vaxom was found to be a valuable drug, supporting antibiotic therapy in recurrent urinary tract infections caused by E. coli.