SAVREMENI PRISTUP NOĆNOM MOKRENJU: PRAKTIČNE SMERNICE ZA PEDIJATRE
DOI:
https://doi.org/10.46793/PP260206004MKljučne reči:
enureza, relaps, dezmopresin, alarm, pedijatrijaApstrakt
Noćno mokrenje (enureza) predstavlja intermitentnu inkontinenciju tokom sna kod dece starije od pet godina i čest je problem sa značajnim medicinskim i psihosocijalnim posledicama. Prevalenca se smanjuje sa uzrastom, ali bez terapije može potrajati do adolescencije. Etiologija je multifaktorska i uključuje genetsku predispoziciju, nesklad između noćne produkcije urina i kapaciteta bešike, smanjeno lučenje vazopresina, kao i funkcionalne poremećaje mokraćne bešike. Psihološki faktori nisu primarni uzrok, ali su česte posledice bolesti. Dijagnostika se zasniva na detaljnoj anamnezi, fizikalnom pregledu, vođenju dnevnika mokrenja i selektivnim analizama, uz jasno razlikovanje monosimptomatske od nemonosimptomatske enureze, što određuje terapijski pristup. Lečenje obuhvata edukaciju porodice, higijensko-dijetetske mere, enureza alarm i dezmopresin kao terapiju prve linije, dok se kod rezistentnih slučajeva primenjuju kombinovane terapije i specijalistička obrada. Uspeh terapije u velikoj meri zavisi od motivacije deteta i roditelja, pravilnog pridržavanja preporuka i lečenja komorbiditeta. Relapsi su mogući, ali se uspešno kontrolišu ponovnim uvođenjem terapije.
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