Department of Paediatric Urology, Public Hospital "Riviera del Brenta",
Dolo, Venice, Italy
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Nocturnal enuresis is urinary incontinence for nighttime, beyond six years. The classical definition of mono-symptomatic nocturnal enuresis assumes a clinical situation without daytime incontinence. Nocturnal enuresis results when the bladder is able to fill to its functional capacity and contracts reflexively during sleep. While nocturnal enuresis is normal in infants, a series of maturational processes, hormonal, neural and structural, results in nocturnal urinary continence by age 5 years in most children. Maturational delay or pathological alteration in one or more of these processes can results in persistent primary enuresis or secondary onset of nocturnal enuresis. However, the tendency to spontaneous resolution of enuresis is equal to 15% per annum. But it’s at the present time accepted that the main principle of enuresis is a sleep trouble: in particular an anomaly of the secretory rhythm of antidiuretic hormone (ADH) is supposed. The treatment of enuresis is identifiable by some parallel courses, at times conjoint. The acoustic alarm requests a good compliance of the family. The employment of the drug Desmopressin, in particular for the events in community of the child, takes on a signification in view of the hypothesis on the reduced nocturnal secretion of ADH. Finally, the employment of anticholinergic drugs is reserved to the situations with an important detrusor instability, instrumentally verified by an urodynamic study, causing some failures with other treatments and some events of diurnal enuresis .
Topics of Interest:
a)Considerations about the pathogenesis b)New considerations about the physiopathology c)The safety and the efficacy of the treatments