1
|
Karamaria S, Ranguelov N, Hansen P, De Boe V, Verleyen P, Segers N, Walle JV, Dossche L, Bael A. Impact of New vs. Old International Children's Continence Society Standardization on the Classification of Treatment Naïve Enuresis Children at Screening: The Value of Voiding Diaries and Questionnaires. Front Pediatr 2022; 10:862248. [PMID: 35419322 PMCID: PMC8995850 DOI: 10.3389/fped.2022.862248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/11/2022] [Indexed: 12/04/2022] Open
Abstract
Expert consensus papers recommend differentiating enuresis using questionnaires and voiding diaries into non- (NMNE) and monosymptomatic enuresis (MNE) is crucial at intake to decide the most appropriate workout and treatment. This national, Belgian, prospective study investigates the correlation, consistency, and added value of the two methods, the new against the old International Children's Continence Society (ICCS) definitions, and documents the prevalence of the two enuresis subtypes in our population. Ninety treatment-naïve enuretic children were evaluated with the questionnaire, and the voiding diary and the two clinical management tools were compared. Almost 30% of the children had a different diagnosis with each method, and we observed inconsistencies between them in registering Lower Tract Symptoms (κ = -0.057-0.432 depending on the symptom). Both methods had a high correlation in identifying MNE (rs = 0.612, p = 0.001) but not for NMNE (rs = 0.127, p = 0.248). According to the latest ICCS definitions, the incidence of MNE was significantly lower (7 vs. 48%) with the old standardization. Conclusion The voiding diary and the questionnaire, as recommended by the ICCS at the screening of treatment-naïve enuretic patients, are considerably inconsistent and have significantly different sensitivities in identifying LUTS and thus differentiating MNE from NMNE. However, the high incidence of LUTS and very low prevalence of MNE suggest that differentiating MNE from NMNE to the maximum might not always correlate with different therapy responses.
Collapse
Affiliation(s)
- Sevasti Karamaria
- Department of Internal Medicine and Pediatrics, Ghent University, ERKNET, Ghent, Belgium
| | - Nadejda Ranguelov
- Department of Pediatrics, Cliniques Universitaires St-Luc, Université catholique de Louvain, Brussels, Belgium
| | | | - Veerle De Boe
- Department of Urology, Brussels University Hospital, Brussels, Belgium
| | | | - Nathalie Segers
- Department of Pediatrics, Pediatric Nephrology, Hospital Network Antwerp (ZNA) Koningin Paola Kinderziekenhuis, Antwerp, Belgium
| | - Johan Vande Walle
- Department of Internal Medicine and Pediatrics, Ghent University, ERKNET, Ghent, Belgium
- Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Lien Dossche
- Department of Internal Medicine and Pediatrics, Ghent University, ERKNET, Ghent, Belgium
- Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium
| | - An Bael
- Department of Pediatrics, Pediatric Nephrology, Hospital Network Antwerp (ZNA) Koningin Paola Kinderziekenhuis, Antwerp, Belgium
- Faculty of Medicine, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
2
|
Dang J, Tang Z. Pathogenesis and brain functional imaging in nocturnal enuresis: A review. Exp Biol Med (Maywood) 2021; 246:1483-1490. [PMID: 33715529 DOI: 10.1177/1535370221997363] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Nocturnal enuresis is a common and distressing developmental disease, which may cause various degrees of psychosocial stress and impairment to self-esteem in affected children as well as agitation to their parents or caregivers. Nevertheless, the etiology and pathogenesis of nocturnal enuresis are not understood. Currently, nocturnal enuresis is generally considered a multifactorial disease associated with a complex interaction of somatic, psychosocial, and environmental factors. A variety of postulations have been proposed to explain the occurrence and progression of nocturnal enuresis, including hereditary aberration, abnormal circadian rhythm of antidiuretic hormone secretion during sleep, bladder dysfunction, abnormal sleep, difficulties in arousal, neuropsychological disorders, and maturational delays of the brain. In recent decades, the introduction of functional neuroimaging technologies has provided new approaches for uncovering the mechanisms underlying nocturnal enuresis. The main neuroimaging modalities have included brain morphometry based on structural magnetic resonance imaging (MRI), task-based and event-related functional MRI (fMRI), and resting-state fMRI. The relevant studies have indicated that nocturnal enuresis is associated with functional and structural alterations of the brain. In this review, we briefly summarized the popular hypotheses regarding the pathogenesis of nocturnal enuresis and the current progress of functional neuroimaging studies in examining the underlying mechanisms thereof.
Collapse
Affiliation(s)
- Jiawen Dang
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.,Sichuan Clinical Research Center for Birth Defects, Luzhou 646000, China
| | - Zhanghua Tang
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.,Sichuan Clinical Research Center for Birth Defects, Luzhou 646000, China
| |
Collapse
|
3
|
Cho WY, Kim SC, Kim SO, Park S, Lee SD, Chung JM, Kim KD, Moon DG, Kim YS, Kim JM. Can recording only the day-time voided volumes predict bladder capacity? Investig Clin Urol 2018; 59:194-199. [PMID: 29744477 PMCID: PMC5934282 DOI: 10.4111/icu.2018.59.3.194] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 01/30/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to demonstrate a method to easily assess bladder capacity using knowledge of day-time voided volumes, which can be obtained even from patients with nocturnal enuresis where the first morning void cannot accurately predict the bladder capacity due to bladder emptying overnight. Materials and Methods We evaluated 177 healthy children from 7 Korean medical centres entered the study between January 2008 and January 2009. Voided volumes measured for more than 48 hours were recorded in the frequency volume chart (FVC). Results Most voided volumes during day-time were showed between 30% and 80% of the maximal voided volume (MVV). The maximal voided volume during day-time (MVVDT) was significantly less than the MVV (179.5±71.1 mL vs. 227.0±79.2 mL, p<0.001). The correlation coefficients with the MVV were 0.801 for the estimated MVV using the MVVDT (MVVDT×1.25), which suggested a fairly strong relationship between the MVVDT×1.25 and the MVV. Conclusions The MVV derived from the FVC excluding the FMV was less than if the FMV had been included. When an accurate first morning voided volume cannot be obtained, as in patients with nocturnal enuresis, calculating MVVDT×1.25 allows estimation of the bladder capacity in place of the MVV.
Collapse
Affiliation(s)
- Won Yeol Cho
- Department of Urology, Dong-A University College of Medicine, Busan, Korea
| | - Seong Cheol Kim
- Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sun-Ouck Kim
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Sungchan Park
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sang Don Lee
- Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jae Min Chung
- Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Kyung Do Kim
- Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Du Geon Moon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Young Sig Kim
- Department of Urology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jun Mo Kim
- Department of Urology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| |
Collapse
|
4
|
ITO K, YASUDA M, MAEDA Y, FUSTIN JM, YAMAGUCHI Y, KONO Y, NEGORO H, KANEMATSU A, OGAWA O, DOI M, OKAMURA H. <b>Circadian rhythms of micturition during jet </b><b>lag </b>. Biomed Res 2018; 39:57-63. [DOI: 10.2220/biomedres.39.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kakeru ITO
- Department of Systems Biology, Graduate School of Pharmaceutical Sciences, Kyoto University
| | - Miho YASUDA
- Department of Systems Biology, Graduate School of Pharmaceutical Sciences, Kyoto University
| | - Yuki MAEDA
- Department of Systems Biology, Graduate School of Pharmaceutical Sciences, Kyoto University
| | - Jean-Michel FUSTIN
- Department of Systems Biology, Graduate School of Pharmaceutical Sciences, Kyoto University
| | - Yoshiaki YAMAGUCHI
- Department of Systems Biology, Graduate School of Pharmaceutical Sciences, Kyoto University
| | - Yuka KONO
- Department of Systems Biology, Graduate School of Pharmaceutical Sciences, Kyoto University
| | - Hiromitsu NEGORO
- Department of Urology, Graduate School of Medicine, Kyoto University
| | - Akihiro KANEMATSU
- Department of Urology, Graduate School of Medicine, Kyoto University
| | - Osamu OGAWA
- Department of Urology, Graduate School of Medicine, Kyoto University
| | - Masao DOI
- Department of Systems Biology, Graduate School of Pharmaceutical Sciences, Kyoto University
| | - Hitoshi OKAMURA
- Department of Systems Biology, Graduate School of Pharmaceutical Sciences, Kyoto University
| |
Collapse
|
5
|
Kamperis K, Van Herzeele C, Rittig S, Vande Walle J. Optimizing response to desmopressin in patients with monosymptomatic nocturnal enuresis. Pediatr Nephrol 2017; 32:217-226. [PMID: 27071997 PMCID: PMC5203827 DOI: 10.1007/s00467-016-3376-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 01/13/2023]
Abstract
Most patients with monosymptomatic nocturnal enuresis can be effectively treated with an enuresis alarm or antidiuretic therapy (desmopressin), depending on the pathophysiology of the condition in the individual patient. Desmopressin is first-line therapy for enuresis caused by nocturnal polyuria, an excessive urine output during the night. However, in a recent study, around one-third of patients thought to be resistant to desmopressin were subsequently treated effectively with desmopressin monotherapy in a specialist centre. The aim of this article is to review best practice in selecting patients for desmopressin treatment, as well as outline eight recommendations for maximizing the chances of treatment success in patients receiving desmopressin. The roles of formulation, dose, timing of administration, food and fluid intake, inter-individual variation in response, body weight, adherence, withdrawal strategies and combination therapies are discussed in light of the most recent research on desmopressin and enuresis. Possible reasons for suboptimal treatment response are explored and strategies to improve outcomes in patients for whom desmopressin is an appropriate therapy are presented. Through optimization of the treatment plan in primary and specialist care centres, the hope is that fewer patients with this distressing and often embarrassing condition will experience unnecessary delays in receiving appropriate care and achieving improvements.
Collapse
Affiliation(s)
- Konstantinos Kamperis
- Department of Pediatrics, Aarhus University Hospital, Skejby, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | | | - Soren Rittig
- Department of Pediatrics, Aarhus University Hospital, Skejby, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
- University of Ghent, Ghent, Belgium
| | - Johan Vande Walle
- Department of Pediatric Nephrology, Safepedrug Consortium, University Hospital Ghent, Ghent, Belgium
| |
Collapse
|
6
|
Sharifi H, Minaie MB, Qasemzadeh MJ, Ataei N, Gharehbeglou M, Heydari M. Topical use of Matricaria recutita L (Chamomile) Oil in the Treatment of Monosymptomatic Enuresis in Children: A Double-Blind Randomized Controlled Trial. J Evid Based Complementary Altern Med 2015; 22:12-17. [PMID: 26427789 DOI: 10.1177/2156587215608989] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 09/06/2015] [Accepted: 09/08/2011] [Indexed: 01/21/2023] Open
Abstract
AIM To evaluate the efficacy of topical use of Matricaria recutita L oil in the treatment of enuresis in children. METHODS Eighty patients diagnosed as monosymptomatic nocturnal or daytime enuresis were allocated to receive Matricaria recutita L (chamomile) oil or placebo topically for 6 weeks in a double-blind randomized placebo-controlled trial with a parallel design. Patients were evaluated prior to and following 8 weeks of the intervention in terms of frequency of enuresis and any observed adverse events. RESULTS The mean frequency of enuresis at the first, second, and third 2 weeks was lower in the intervention group compared with the placebo group, and the differences were statistically significant (P < .001, P = .03, and P < .001, respectively). There was no report of any adverse event in the study groups. CONCLUSION The findings of this study showed that the topical use of (chamomile) oil can decrease the frequency of nocturia in children with monosymptomatic nocturnal or daytime enuresis.
Collapse
Affiliation(s)
- Hosein Sharifi
- Persian Medicine & Pharmacy Research Center, School of traditional Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Bagher Minaie
- Persian Medicine & Pharmacy Research Center, School of traditional Medicine, Tehran University of Medical Science, Tehran, Iran
| | | | - Nematollah Ataei
- Department of Pediatric Nephrology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mojtaba Heydari
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
7
|
Abstract
The objective is to provide a review of nocturnal enuresis (NE), including its epidemiology, etiology, pathophysiology, evaluation, and current management. We also set to provide further insight on the treatment of this condition from the experience derived from patients cared for at our tertiary-care institution. NE affects approximately 15% of all children at 5-year-old, affecting boys more frequently than girls. At our large university tertiary pediatric urology center, NE and incontinence, in general, is one the most common chief complaints prompting urologic care. In this review, we examine the condition in detail, highlighting specific goals of the initial evaluation and treatment. We contrast the commonly implemented treatment recommendations, available from the literature with strategies we have found valuable from our extensive experience in treating patients with this disorder. Using current urologic reference textbooks, book chapters, Medline, journal articles and reviews describing the many aspects of NE were reviewed in order to describe NE and the current practices at our institution. Although, this is not a systematic literature review, it includes relevant available research, institutional experience and urological expert opinion and current practices at a tertiary state health facility. The treatment of NE remains a challenge for many pediatricians and pediatric urologists. This likely stems from the multiple possible etiologies of the disorder. We have established a treatment algorithm at our institution, which we have found successful in the majority of our patients. This consists of starting patients on urotherapy, then offering both the enuresis alarm device and medication therapy as first line treatments, and finally adding anticholingerics for combination therapy. Our hope is with further research the treatment of NE will continue to improve.
Collapse
Affiliation(s)
| | - Chad Morley
- Department of Surgery, Division of Urology, West Virginia University Robert C. Byrd Sciences Center, Morgantown, WV, USA
| | - Osama Al-Omar
- Department of Surgery, Division of Urology, West Virginia University Robert C. Byrd Sciences Center, Morgantown, WV, USA
| |
Collapse
|
8
|
Chiang CY, Fan YH, Lin ATL, Chen KK. First morning voided volume as a valuable tool for evaluating patients with overactive bladder. UROLOGICAL SCIENCE 2014. [DOI: 10.1016/j.urols.2014.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
9
|
van Gool JD. Re: Martínez-García R, Ubeda-Sansano MI, Díez-Domingo J, Pérez-Hoyos S, Gil-Salom M. It is time to abandon “Expected bladder capacity.” Systematic review and new models for children's normal maximum voided volumes. Neurourol Urodyn 2014;33:1092-8. Neurourol Urodyn 2014; 33:1099. [DOI: 10.1002/nau.22622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 04/02/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Jan D. van Gool
- Institute of Medical Informatics, Biometry, and Epidemiology; University Hospital Essen; Essen Germany
| |
Collapse
|
10
|
Wen JG, Lu YT, Cui LG, Bower WF, Rittig S, Djurhuus JC. Bladder function development and its urodynamic evaluation in neonates and infants less than 2 years old. Neurourol Urodyn 2014; 34:554-60. [PMID: 24788785 DOI: 10.1002/nau.22626] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Accepted: 04/02/2014] [Indexed: 12/19/2022]
Affiliation(s)
- Jian Guo Wen
- Pediatric Urodynamic Centre; First Affiliated Hospital of Zhengzhou University; Zhengzhou P.R. China
| | - Yu Tao Lu
- Pediatric Urodynamic Centre; First Affiliated Hospital of Zhengzhou University; Zhengzhou P.R. China
| | - Lin Gang Cui
- Pediatric Urodynamic Centre; First Affiliated Hospital of Zhengzhou University; Zhengzhou P.R. China
| | - Wendy Fiona Bower
- Department of Epidemiology and Preventive Medicine; School of Public Health, Monash University; Melbourne Australia
| | - Soren Rittig
- Department of Paediatrics; Aarhus University Hospital; Aarhus N Denmark
| | | |
Collapse
|
11
|
Chronobiology of Micturition: Putative Role of the Circadian Clock. J Urol 2013; 190:843-9. [DOI: 10.1016/j.juro.2013.02.024] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2013] [Indexed: 12/13/2022]
|
12
|
Martínez-García R, Úbeda-Sansano MI, Díez-Domingo J, Pérez-Hoyos S, Gil-Salom M. It is time to abandon “Expected bladder capacity.” Systematic review and new models for children's normal maximum voided volumes. Neurourol Urodyn 2013; 33:1092-8. [DOI: 10.1002/nau.22452] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 05/30/2013] [Indexed: 11/10/2022]
Affiliation(s)
| | | | - Javier Díez-Domingo
- Vaccine Institute of Valencia; Valencia Spain
- Vaccine Research Department; Center for Public Health Research (CSISP), FISABIO of Valencia; Valencia Spain
| | - Santiago Pérez-Hoyos
- Unitat Suport Metodològic a l'Investigació Biomedica (USMIB); Institut de Recerca Hospital Vall Hebrón; Barcelona Spain
| | - Manuel Gil-Salom
- Department of Surgery; University of Valencia; Valencia Spain
- Department of Urology; Dr. Peset Hospital of Valencia; Valencia Spain
| |
Collapse
|
13
|
Negoro H, Kanematsu A, Matsuo M, Okamura H, Tabata Y, Ogawa O. Development of Diurnal Micturition Pattern in Mice After Weaning. J Urol 2013; 189:740-6. [DOI: 10.1016/j.juro.2012.07.140] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2012] [Indexed: 11/25/2022]
Affiliation(s)
- Hiromitsu Negoro
- Department of Urology, Graduate School of Medicine, Kyoto University, Sakyo, Kyoto, Japan
- Department of Biomaterials, Institute for Frontier Medical Sciences, Kyoto University, Sakyo, Kyoto, Japan
| | - Akihiro Kanematsu
- Department of Urology, Graduate School of Medicine, Kyoto University, Sakyo, Kyoto, Japan
- Department of Urology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Masahiro Matsuo
- Department of Systems Biology, Graduate School of Pharmaceutical Sciences, Kyoto University, Sakyo, Kyoto, Japan
| | - Hitoshi Okamura
- Department of Systems Biology, Graduate School of Pharmaceutical Sciences, Kyoto University, Sakyo, Kyoto, Japan
| | - Yasuhiko Tabata
- Department of Biomaterials, Institute for Frontier Medical Sciences, Kyoto University, Sakyo, Kyoto, Japan
| | - Osamu Ogawa
- Department of Urology, Graduate School of Medicine, Kyoto University, Sakyo, Kyoto, Japan
| |
Collapse
|
14
|
Negoro H, Kanematsu A, Doi M, Suadicani SO, Matsuo M, Imamura M, Okinami T, Nishikawa N, Oura T, Matsui S, Seo K, Tainaka M, Urabe S, Kiyokage E, Todo T, Okamura H, Tabata Y, Ogawa O. Involvement of urinary bladder Connexin43 and the circadian clock in coordination of diurnal micturition rhythm. Nat Commun 2012; 3:809. [PMID: 22549838 PMCID: PMC3541943 DOI: 10.1038/ncomms1812] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 03/30/2012] [Indexed: 01/27/2023] Open
Abstract
Nocturnal enuresis in children and nocturia in the elderly are two highly prevalent clinical conditions characterized by a mismatch between urine production rate in the kidneys and storage in the urinary bladder during the sleep phase. Here we demonstrate, using a novel method for automated recording of mouse micturition, that connexin43 (Cx43), a bladder gap junction protein, is a negative regulator of functional bladder capacity. Bladder Cx43 levels and functional capacity show circadian oscillations in wild-type mice, but such rhythms are completely lost in Cry-null mice having a dysfunctional biological clock. Bladder muscle cells have an internal clock, and show oscillations of Cx43 and gap junction function. A clock regulator, Rev-erbα, upregulates Cx43 transcription as a co-factor of Sp1 using Sp1 cis-elements of the promoter. Therefore, circadianoscillation of Cx43 is associated with the biological clock and contributes to diurnal changes in bladder capacity, which avoids disturbance of sleep by micturition.
Collapse
Affiliation(s)
- Hiromitsu Negoro
- Department of Urology, Graduate School of Medicine, Kyoto University, Sakyo, Kyoto 606-8507, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Kim JM. Diagnostic value of functional bladder capacity, urine osmolality, and daytime storage symptoms for severity of nocturnal enuresis. Korean J Urol 2012; 53:114-9. [PMID: 22379591 PMCID: PMC3285706 DOI: 10.4111/kju.2012.53.2.114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 10/13/2011] [Indexed: 11/25/2022] Open
Abstract
Purpose To investigate the correlation between functional bladder capacity, first morning urine osmolality, daytime voiding symptoms, and severity of nocturnal enuresis. Materials and Methods We assessed a total of 101 children with nocturnal enuresis (mean age, 7.7±2.3 years). Patients were divided into three groups according to the severity of enuresis: (1) one to six episodes per week (46 cases, 45.5%), (2) one episode every day (29 cases, 28.7%), and (3) multiple episodes every day (26 cases, 25.8%). Baseline parameters were obtained from frequency volume charts for 2 days, first morning urine osmolality, and a questionnaire for the presence of frequency, urgency, and daytime incontinence. Results The severity of enuresis increased with younger age (p=0.037) and reduced functional bladder capacity (p=0.007) and daytime symptoms of frequency and daytime incontinence (p=0.012, p=0.036). No statistical difference in urine osmolality or urgency was found among the three groups. Both reduced functional bladder capacity and low urine osmolality increased according to the severity of enuresis (p=0.012). Conclusions In children with nocturnal enuresis, severity was increased by younger age, reduced functional bladder capacity, and the presence of daytime voiding symptoms of frequency and daytime incontinence. The incidence of small functional bladder capacity was increased in children with everyday wetting, and the incidences of both small functional bladder capacity and low urine osmolality were increased in children with everyday multiple wetting.
Collapse
Affiliation(s)
- Jun-Mo Kim
- Department of Urology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Korea
| |
Collapse
|
16
|
Montaldo P, Tafuro L, Rea M, Narciso V, Iossa AC, Gado RD. Desmopressin and oxybutynin in monosymptomatic nocturnal enuresis: a randomized, double-blind, placebo-controlled trial and an assessment of predictive factors. BJU Int 2012; 110:E381-6. [DOI: 10.1111/j.1464-410x.2011.10918.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
17
|
Circadian rhythms in urinary functions: possible roles of circadian clocks? Int Neurourol J 2011; 15:64-73. [PMID: 21811695 PMCID: PMC3138846 DOI: 10.5213/inj.2011.15.2.64] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 06/20/2011] [Indexed: 12/12/2022] Open
Abstract
Circadian clocks are the endogenous oscillators that harmonize a variety of physiological processes within the body. Although many urinary functions exhibit clear daily or circadian variation in diurnal humans and nocturnal rodents, the precise mechanisms of these variations are as yet unclear. In this review, we briefly introduce circadian clocks and their organization in mammals. We then summarize known daily or circadian variations in urinary function. Importantly, recent findings by others as well as results obtained by us suggest an active role of circadian clock genes in various urinary functions. Finally, we discuss possible research avenues for the circadian control of urinary function.
Collapse
|
18
|
Zhang T, Wu Q, Sun HW, Rao J, Kannan K. Perchlorate and iodide in whole blood samples from infants, children, and adults in Nanchang, China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2010; 44:6947-6953. [PMID: 20715770 DOI: 10.1021/es101354g] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Perchlorate, ClO(4)(-), interferes with iodide (I(-)) uptake by the sodium-iodide symporter (NIS) and thereby affects thyroid hormone production in the body. Studies have reported human exposures to perchlorate based on measurements in urine, but little is known about the levels in blood. In this study, we determined concentrations of perchlorate, iodide, and other anions (e.g., chlorate [ClO(3)(-)], bromate [BrO(3)(-)], bromide [Br(-)]) in 131 whole blood samples collected from Chinese donors aged 0.4 to 90 yr, in Nanchang, China. Perchlorate, iodide, and bromide were detected in all of the samples analyzed, whereas chlorate was found in only 27% of the samples and bromate was found in only 2%. The mean (range) concentrations of perchlorate, iodide, and bromide were 2.68 (0.51-10.5), 42.6 (1.58-812), and 2120 (1050-4850) ng/mL, respectively. Perchlorate levels in blood from Nanchang adults were 10-fold greater than levels that have been previously reported for U.S. adults. The iodide/perchlorate molar ratio ranged from 3.05 to 15.3 for all age groups, and the ratio increased with age (r = 0.732, p < 0.01). Perchlorate and bromide concentrations decreased significantly with age, whereas iodide concentrations increased with age. No significant gender-related differences in blood perchlorate, iodide, or bromide levels were found. A significant negative correlation was found between the concentrations of perchlorate and iodide in blood. Exposure doses of perchlorate were estimated for infants, toddlers, children, adolescents, and adults based on the measured concentrations in blood, using a simple pharmacokinetic model. The mean exposure doses of perchlorate for our age groups ranged from 1.12 (adults) to 2.22 μg/kg bw/day (infants), values higher than the United States Environmental Protection Agency's (USEPA) reference dose (RfD: 0.7 μg/kg bw/day). This is the first study on perchlorate and iodide levels in whole blood from infants, toddlers, children, adolescents, and adults from a city in China with known high perchlorate levels.
Collapse
Affiliation(s)
- Tao Zhang
- MOE Key Laboratory of Pollution Processes and Environmental Criteria, Nankai University, Tianjin 300071, China
| | | | | | | | | |
Collapse
|
19
|
Van de Walle J, Van Herzeele C, Raes A. Is there still a role for desmopressin in children with primary monosymptomatic nocturnal enuresis?: a focus on safety issues. Drug Saf 2010; 33:261-71. [PMID: 20297859 DOI: 10.2165/11319110-000000000-00000] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
It has recently became apparent that severe primary monosymptomatic nocturnal enuresis (MNE) has a worse prognosis than generally believed, and may have major consequences on the well-being of the child, thus making treatment mandatory. Desmopressin is one of the most widely prescribed medications for MNE, and in this current opinion article we discuss the safety of desmopressin in children with this condition. Following a US FDA request in December 2007 that the prescribing information for desmopressin nasal spray be updated, desmopressin spray is no longer indicated for the treatment of MNE or for use in patients at risk for hyponatraemia. Multiple reports of hyponatraemia in patients with nocturia (mainly the elderly) led to an increased awareness of the risks associated with desmopressin. While the pathogenesis of hyponatraemia in those over 65 years of age relates more to changing renal water and solute handling, we believe that in the young, overdosing and insufficient fluid restriction are usually the major causes. Hyponatraemia is most frequently reported when desmopressin is administered by nasal spray compared with the tablet formulation. This may simply reflect the fact that for more than 10 years the spray was the only available mode of administration in many countries. However, it may also reflect the higher biodisponibility and/or intraindividual variability of pharmacokinetics of the spray compared with the tablet. There are few serious adverse events reported for the melt formulation (oral lyophilisate), but as it has only recently become available on the market, it would be premature to conclude that it has a better safety profile. We believe that desmopressin in all formulations has a good safety profile in children with MNE, provided that treatment is properly prescribed and monitored; improving the training of doctors and patients in the dose-response kinetics of the drug, teaching appropriate restriction of fluid intake and by encouraging the use of desmopressin within a narrow dose range (10-20 microg spray, 120-240 microg melt and 200-400 microg tablet) when used in primary-care settings. Titrating higher doses in therapy-resistant patients should probably be carried out in a specialized enuresis centre, and only after documenting adequate morning urinary diluting capacity. In summary, the risk of hyponatraemia is exacerbated by misuse of the drug rather than an inherent danger associated with the drug, which in our opinion should be addressed with better education rather than withdrawal of a medication that has the potential to benefit children with nocturnal enuresis.
Collapse
Affiliation(s)
- Johan Van de Walle
- Department of Pediatric Nephrology, University Hospital Ghent, Ghent, Belgium.
| | | | | |
Collapse
|
20
|
Van Hoeck K. Editorial Comment. J Urol 2010; 183:1567. [DOI: 10.1016/j.juro.2009.12.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Koen Van Hoeck
- Department Pediatric Nephrology, University Hospital Antwerp, Antwerp, Belgium
| |
Collapse
|
21
|
Abstract
PURPOSE OF REVIEW To highlight recent advances in enuresis research. RECENT FINDINGS Many discoveries have distanced us from the time when bedwetting was considered a psychiatric disorder. Instead, it is now agreed that nocturnal polyuria, detrusor overactivity, and high arousal thresholds are, in various combinations, central to enuresis pathogenesis. All three mechanisms have been further elucidated during the last year. It has been found that solute diuresis, and not just free-water diuresis due to vasopressin deficiency, may be causative. Sonographical bladder wall measurements have been shown to have prognostic value in detrusor-dependent enuresis, and fascinating proof for the interplay between the bladder and the sleeping brain has been put forward. And, ironically, sleep research has caused psychiatry to make a slight comeback, as studies have indicated that enuretic children may suffer from cognitive problems due to suboptimal sleep. Less has been achieved regarding treatment, but some evidence has finally supported the experience that anticholinergics may be effective in therapy-resistant enuresis. SUMMARY During the last years, increased insight has been gained into the multifaceted pathogenesis of enuresis, but there is still an irritating lack of proven effective therapies.
Collapse
|
22
|
Re: Do Holding Exercises or Antimuscarinics Increase Maximum Voided Volume in Monosymptomatic Nocturnal Enuresis? A Randomized Controlled Trial in Children. J Urol 2008; 179:2485; author reply 2485-6. [DOI: 10.1016/j.juro.2008.01.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2007] [Indexed: 11/22/2022]
|
23
|
Van Hoeck KJ, Bael A, Lax H, Hirche H, Bernaerts K, Vandermaelen V, van Gool JD. Improving the Cure Rate of Alarm Treatment for Monosymptomatic Nocturnal Enuresis by Increasing Bladder Capacity—A Randomized Controlled Trial in Children. J Urol 2008; 179:1122-6; discussion 1126-7. [PMID: 18206946 DOI: 10.1016/j.juro.2007.10.096] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Indexed: 10/22/2022]
Affiliation(s)
- Koen J. Van Hoeck
- Department of Pediatrics, University Hospital Antwerp, Antwerp, Belgium
| | - An Bael
- Department of Pediatrics, University Hospital Antwerp, Antwerp, Belgium
| | - Hildegard Lax
- Institute for Medical Informatics, Biometry and Epidemiology, Essen University, Essen, Germany
| | - Herbert Hirche
- Institute for Medical Informatics, Biometry and Epidemiology, Essen University, Essen, Germany
| | - Kim Bernaerts
- Department of Pediatrics, University Hospital Antwerp, Antwerp, Belgium
| | | | - Jan D. van Gool
- Department of Pediatrics, University Hospital Antwerp, Antwerp, Belgium
| |
Collapse
|
24
|
Jackson EC. Is lack of bladder inhibition during sleep a mechanism of nocturnal enuresis? J Pediatr 2007; 151:559-60. [PMID: 18035127 DOI: 10.1016/j.jpeds.2007.06.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Accepted: 06/28/2007] [Indexed: 11/25/2022]
|