J Korean Med Assoc.  2017 Oct;60(10):796-799. 10.5124/jkma.2017.60.10.796.

Pharmacological therapy of nocturnal enuresis

Affiliations
  • 1Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea.
  • 2Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea. pedksh@gmail.com

Abstract

Nocturnal enuresis is a common problem of children during sleeping at preschool or school age. It may affect negatively the psychosocial development of children. Children with enuresis may have lower self-esteem and lower quality of life. There are three main factors of the pathophysiology of enuresis: high nocturnal urine production, nocturnal low bladder capacity or increased detrusor muscle activity, and arousal disorder. As pharmacological therapy for nocturnal enuresis, several medications including desmopressin, anticholinergics, imipramine have been used for a long time. As first-line therapy, desmopressin combined with anticholinergics has good response in primary monosymptomatic nocturnal enuresis. Because imipramine has serious and lethal cardiotoxic effect with overdosage, imipramine should be prescribed after EKG to rule out the conduction problem of heart.

Keyword

Nocturnal enuresis; Desmopressin; Anticholinergics; Imipramine

MeSH Terms

Arousal
Child
Cholinergic Antagonists
Deamino Arginine Vasopressin
Electrocardiography
Enuresis
Heart
Humans
Imipramine
Nocturnal Enuresis*
Quality of Life
Urinary Bladder
Cholinergic Antagonists
Deamino Arginine Vasopressin
Imipramine

Cited by  1 articles

Current management scheme of nocturnal enuresis
Kwanjin Park
J Korean Med Assoc. 2017;60(10):790-791.    doi: 10.5124/jkma.2017.60.10.790.


Reference

1. Lundgren R. Nocturia: a new perspective on an old symptom. Scand J Urol Nephrol. 2004; 38:112–116.
Article
2. Ozden C, Ozdal OL, Altinova S, Oguzulgen I, Urgancioglu G, Memis A. Prevalence and associated factors of enuresis in Turkish children. Int Braz J Urol. 2007; 33:216–222.
Article
3. Butler RJ, Golding J, Northstone K. ALSPAC Study Team. Nocturnal enuresis at 7.5 years old: prevalence and analysis of clinical signs. BJU Int. 2005; 96:404–410.
Article
4. Hong CH, Baek MK, Lee SH, Lee JW, Pai KS. Diagnosis and treatment of nocturnal enuresis in children. Korean J Pediatr. 2008; 11:1140–1146.
Article
5. Neveus T, Eggert P, Evans J, Macedo A, Rittig S, Tekgul S, Vande Walle J, Yeung CK, Robson L. International Child-ren's Continence Society. Evaluation of and treatment for monosymptomatic enuresis: a standardization document from the International ChildrenXMLLink_XYZs Continence Society. J Urol. 2010; 183:441–447.
Article
6. Kamperis K, Rittig S, Radvanska E, Jorgensen KA, Djurhuus JC. The effect of desmopressin on renal water and solute handling in desmopressin resistant monosymptomatic noc-turnal enuresis. J Urol. 2008; 180:707–713.
Article
7. Juul KV, Van Herzeele C, De Bruyne P, Goble S, Walle JV, Norgaard JP. Desmopressin melt improves response and compliance compared with tablet in treatment of primary monosymptomatic nocturnal enuresis. Eur J Pediatr. 2013; 172:1235–1242.
Article
8. Robson WL, Leung AK, Norgaard JP. The comparative safety of oral versus intranasal desmopressin for the treatment of children with nocturnal enuresis. J Urol. 2007; 178:24–30.
Article
9. Hjalmas K, Hanson E, Hellstrom AL, Kruse S, Sillen U. Long-term treatment with desmopressin in children with primary monosymptomatic nocturnal enuresis: an open multicentre study. Swedish Enuresis Trial (SWEET) Group. Br J Urol. 1998; 82:704–709.
Article
10. Lister-Sharp D, O'Meara S, Bradley M, Sheldon TA. A systematic review of the effectiveness of interventions for managing childhood nocturnal enuresis. York: University of York;1997.
11. Yeung CK, Sit FK, To LK, Chiu HN, Sihoe JD, Lee E, Wong C. Reduction in nocturnal functional bladder capacity is a common factor in the pathogenesis of refractory nocturnal enuresis. BJU Int. 2002; 90:302–307.
Article
12. Lovering JS, Tallett SE, McKendry JB. Oxybutynin efficacy in the treatment of primary enuresis. Pediatrics. 1988; 82:104–106.
Article
13. Austin PF, Ferguson G, Yan Y, Campigotto MJ, Royer ME, Coplen DE. Combination therapy with desmopressin and an anticholinergic medication for nonresponders to desmopressin for monosymptomatic nocturnal enuresis: a randomized, double-blind, placebo-controlled trial. Pediatrics. 2008; 122:1027–1032.
Article
14. Nijman RJ, Butler R, van Gool J, Yeung CK, Bower W, Hjalmas K. Conservative management of urinary inconti-nence in children. In : Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. 2nd ed. Plymouth: Health Publi-cation;2002. p. 515–551.
15. Hjalmas K, Arnold T, Bower W, Caione P, Chiozza LM, von Gontard A, Han SW, Husman DA, Kawauchi A, LAckgren G, Lottmann H, Mark S, Rittig S, Robson L, Walle JV, Yeung CK. Nocturnal enuresis: an international evidence based manage-ment strategy. J Urol. 2004; 171(6 Pt 2):2545–2561.
Article
16. Neveus T, Tullus K. Tolterodine and imipramine in refractory enuresis: a placebo-controlled crossover study. Pediatr Neph-ro. 2008; 23:263–267.
Article
17. Glazener CM, Evans JH. Simple behavioural and physical interventions for nocturnal enuresis in children. Cochrane Database Syst Rev. 2004; (2):CD003637.
Article
18. Park SJ, Park JM, Pai KS, Ha TS, Lee SD, Baek M. Korean Children's Continence and Enuresis Society. Desmopressin alone versus desmopressin and an anticholinergic in the first-line treatment of primary monosymptomatic nocturnal enu-resis: a multicenter study. Pediatr Nephrol. 2014; 29:1195–1200.
Article
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr