Management and treatment of nocturnal enuresis-an updated standardization document from the International Children's Continence Society.

Child Humans Nocturnal Enuresis / diagnosis
Anticholinergics Antidepressants Comorbidity Desmopressin Enuresis Enuresis alarm

Journal

Journal of pediatric urology
ISSN: 1873-4898
Titre abrégé: J Pediatr Urol
Pays: England
ID NLM: 101233150

Informations de publication

Date de publication:
Feb 2020
Historique:
received: 25 10 2019
accepted: 30 12 2019
pubmed: 13 4 2020
medline: 5 3 2021
entrez: 13 4 2020
Statut: ppublish

Résumé

Enuresis is an extremely common condition, which, although somatically benign, poses long-term psychosocial risks if untreated. There are still many misconceptions regarding the proper management of these children. A cross-professional team of experts affiliated with the International Children's Continence Society (ICCS) undertook to update the previous guidelines for the evaluation and treatment of children with enuresis. The document used the globally accepted ICCS terminology. Evidence-based literature served as the basis, but in areas lacking in primary evidence, expert consensus was used. Before submission, a full draft was made available to all ICCS members for additional comments. The enuretic child does, in the absence of certain warning signs (i.e., voiding difficulties, excessive thirst), not need blood tests, radiology or urodynamic assessment. Active therapy is recommended from the age of 6 years. The most important comorbid conditions to take into account are psychiatric disorders, constipation, urinary tract infections and snoring or sleep apneas. Constipation and daytime incontinence, if present, should be treated. In nonmonosymptomatic enuresis, it is recommended that basic advice regarding voiding and drinking habits be provided. In monosymptomatic enuresis, or if the above strategy did not make the child dry, the first-line treatment modalities are desmopressin or the enuresis alarm. If both these therapies fail alone or in combination, anticholinergic treatment is a possible next step. If the child is unresponsive to initial therapy, antidepressant treatment may be considered by the expert. Children with concomitant sleep disordered breathing may become dry if the airway obstruction is removed.

Sections du résumé

BACKGROUND BACKGROUND
Enuresis is an extremely common condition, which, although somatically benign, poses long-term psychosocial risks if untreated. There are still many misconceptions regarding the proper management of these children.
AIM OBJECTIVE
A cross-professional team of experts affiliated with the International Children's Continence Society (ICCS) undertook to update the previous guidelines for the evaluation and treatment of children with enuresis.
METHODS METHODS
The document used the globally accepted ICCS terminology. Evidence-based literature served as the basis, but in areas lacking in primary evidence, expert consensus was used. Before submission, a full draft was made available to all ICCS members for additional comments.
RESULTS RESULTS
The enuretic child does, in the absence of certain warning signs (i.e., voiding difficulties, excessive thirst), not need blood tests, radiology or urodynamic assessment. Active therapy is recommended from the age of 6 years. The most important comorbid conditions to take into account are psychiatric disorders, constipation, urinary tract infections and snoring or sleep apneas. Constipation and daytime incontinence, if present, should be treated. In nonmonosymptomatic enuresis, it is recommended that basic advice regarding voiding and drinking habits be provided. In monosymptomatic enuresis, or if the above strategy did not make the child dry, the first-line treatment modalities are desmopressin or the enuresis alarm. If both these therapies fail alone or in combination, anticholinergic treatment is a possible next step. If the child is unresponsive to initial therapy, antidepressant treatment may be considered by the expert. Children with concomitant sleep disordered breathing may become dry if the airway obstruction is removed.

Identifiants

DOI: 10.1016/j.jpurol.2019.12.020 PMID: 32278657
pubmed: 32278657
pii: S1477-5131(20)30001-2
doi: 10.1016/j.jpurol.2019.12.020
pii:
doi:

Types de publication

Journal Article Practice Guideline Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

10-19

Informations de copyright

Copyright © 2020 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Auteurs

Tryggve Nevéus (T)

Department of Women's and Children's Health, Uppsala University, Uppsala, 75185, Sweden. Electronic address: tryggve.neveus@kbh.uu.se.

Eliane Fonseca (E)

University of Rio de Janeiro State, Souza Marques School of Medicine, Pediatric Urodynamic Unit, Rio de Janeiro, Brazil.

Israel Franco (I)

Yale New Haven Children's Bladder and Continence Program, Yale-New Haven Hospital, New Haven, CT, 06520, USA.

Akihiro Kawauchi (A)

Department of Urology, Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan.

Larisa Kovacevic (L)

Michigan State University, Department of Pediatric Urology, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI, 48201, USA.

Anka Nieuwhof-Leppink (A)

Department of Medical Psychology and Social Work, Urology, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, Utrecht, 3508 AB, The Netherlands.

Ann Raes (A)

Department of Pediatric Nephrology, Ghent University Hospital, C. Heymanslaan 10, Gent, 9000, Belgium.

Serdar Tekgül (S)

Hacettepe University, Department of Pediatric Urology, Ankara, Turkey.

Stephen S Yang (SS)

Department of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi University, New Taipei, Taiwan.

Søren Rittig (S)

Department of Pediatrics, Skejby Sygehus, Aarhus University Hospital, Aarhus N, 8200, Denmark.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Management and treatment of nocturnal...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Management and treatment of nocturnal...
questionsmedicales.fr › Troubles mentaux › Troubles de l'élimination › Énurésie › Énurésie nocturne › Management and treatment of nocturnal...