CONTEMPORARY APPROACH TO NOCTURNAL ENURESIS: PRACTICAL GUIDELINES FOR PEDIATRICIANS
DOI:
https://doi.org/10.46793/PP260206004MKeywords:
enuresis, relapse, desmopressin, alarm, pediatricsAbstract
Nocturnal enuresis is defined as intermittent urinary incontinence during sleep in children older than five years and represents a common condition with relevant medical and psychosocial impact. Its prevalence decreases with age, yet without treatment it may persist into adolescence. The etiology is multifactorial, involving genetic predisposition, imbalance between nocturnal urine production and bladder capacity, reduced nocturnal vasopressin secretion, and functional bladder disorders. Psychological factors are not primary causes but often arise as consequences of the condition. Diagnosis relies on careful history taking, physical examination, voiding diaries, and selective laboratory testing, with clear differentiation between monosymptomatic and non-monosymptomatic enuresis, which guides management. Treatment includes education, lifestyle and fluid-intake modifications, enuresis alarm therapy, and desmopressin as first-line options, while resistant cases may require combination therapy and specialist evaluation. Treatment success largely depends on adherence, family motivation, and management of comorbidities, and relapses can be effectively managed with repeated therapy.
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