1
|
Correia Moretti E, da Silva IB, Boaviagem A, de Lima AMJ, Lemos A. Interventions for Enuresis in Children and Adolescents: An Overview of Systematic Reviews. Curr Pediatr Rev 2024; 20:76-88. [PMID: 36043721 DOI: 10.2174/1573396318666220827103731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/06/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Enuresis is an involuntary and intermittent loss of urine during sleep, and its treatment can be done by pharmacological and non-pharmacological strategies. OBJECTIVE To conduct an overview to carry out a survey of the systematic reviews about treatment options for children/adolescents with enuresis. METHODS Databases used were Cochrane Library, PROSPERO, MEDLINE/PubMed, EMBASE, LILACS/BVS, PEDro, SciELO and Google Scholar. Any type of intervention for the treatment of enuresis in children/adolescents was selected by two independent researchers. Data extraction was done by two independent researchers. The risk of bias was assessed using Risk of Bias in Systematic Reviews (ROBIS) and A MeaSurement Tool to Assess Systematic Reviews (AMSTAR-2). RESULTS Seven systematic reviews were included. According to ROBIS, three reviews had a low risk of bias, while the others had a high risk of bias. Based on AMSTAR-2, four systematic reviews were of moderate quality, two were low quality, and one was critically low quality. CONCLUSION There is moderate confidence that the use of desmopressin plus an anticholinergic agent increases the chance of complete response compared to desmopressin alone. Neurostimulation may increase the risk of responses ≥50% and ≥90% compared to the control group. Likewise, it appears that electrical stimulation is superior to placebo about the chance of response ≥50%. In addition, there is clinical relevance in reducing enuresis episodes per week when neurostimulation is used compared to control groups.
Collapse
Affiliation(s)
- Eduarda Correia Moretti
- Department of Anatomy, Federal University of Pernambuco, Child and Adolescent Health, Federal University of Pernambuco - Recife (PE), Brazil
- Institute of Biological and Health Sciences, Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
| | | | - Alessandra Boaviagem
- Department of Physiotherapy, Federal University of Pernambuco - Recife (PE), Brazil
| | | | - Andrea Lemos
- Department of Physical Therapy, Federal University of Pernambuco, Recife (PE), Brazil
| |
Collapse
|
2
|
Botla AM, Mustafa JH, Abd-Elmonem AM, Sayed MD, Shehata MMA. Effect of laser acupuncture on monosymptomatic nocturnal enuresis in adolescent females: A randomized controlled trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2048. [PMID: 37664896 DOI: 10.1002/pri.2048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/01/2023] [Accepted: 08/23/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND AND AIM Nocturnal enuresis (NE) is prevalent in children and adolescents and affects their social life later. Therefore, the objective of this study was to ascertain laser acupuncture (LA) therapy's effect on NE in adolescent females. METHODS Sixty adolescent females diagnosed with chronic monosymptomatic nocturnal enuresis (MNE) were randomly divided into two equal groups: The intervention group (received LA and desmopressin) and the control group (received desmopressin only) (n = 30 each). Treatment was delivered and LA was used three times a week for 12 successive weeks. Abdominal ultrasonography and voiding calendar were used to assess bladder capacity and maximum voiding volume (MVV), respectively. The frequency of bed wetness was assessed throughout the trial period in a diary. RESULTS Statistically significant differences were reported in the intervention group. Bladder capacity significantly increased in the intervention group (LA and desmopressin) than in the control group. CONCLUSIONS The results of this study suggest the beneficial influences of LA on MNE, despite the very poor quality of the literature's available evidence.
Collapse
Affiliation(s)
- Afaf M Botla
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Jehan H Mustafa
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Merit University, Sohag, Egypt
| | - Amira M Abd-Elmonem
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Mohamed D Sayed
- Department of Urology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mai M A Shehata
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| |
Collapse
|
3
|
Harris J, Lipson A, Dos Santos J. L'évaluation et la prise en charge de l'énurésie en pédiatrie générale. Paediatr Child Health 2023; 28:362-376. [PMID: 37744754 PMCID: PMC10517247 DOI: 10.1093/pch/pxad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 10/26/2022] [Indexed: 09/26/2023] Open
Abstract
Pour évaluer l'énurésie, un trouble pédiatrique courant, il faut en distinguer la forme monosymptomatique de la forme non monosymptomatique et établir la présence d'affections concomitantes. La prise en charge simultanée des facteurs cooccurrents est le meilleur moyen pour obtenir un résultat satisfaisant. Le traitement commence par l'éducation du patient et de sa famille sur l'évolution naturelle de l'énurésie et par des conseils pratiques sur le comportement. Les données probantes en appui à des interventions particulières sont limitées, et les enfants et les familles devraient participer au choix du traitement approprié. Les dispositifs d'alarme contre l'énurésie et la desmopressine représentent des possibilités thérapeutiques lorsqu'une intervention plus active est souhaitée. Des améliorations cliniques et des traitements combinés sont en voie de se dégager.
Collapse
Affiliation(s)
- James Harris
- Société canadienne de pédiatrie, comité de la pédiatrie communautaire, Ottawa (Ontario)Canada
| | - Alisa Lipson
- Société canadienne de pédiatrie, comité de la pédiatrie communautaire, Ottawa (Ontario)Canada
| | - Joana Dos Santos
- Société canadienne de pédiatrie, comité de la pédiatrie communautaire, Ottawa (Ontario)Canada
| |
Collapse
|
4
|
Harris J, Lipson A, Dos Santos J. Evaluation and management of enuresis in the general paediatric setting. Paediatr Child Health 2023; 28:362-376. [PMID: 37744753 PMCID: PMC10517245 DOI: 10.1093/pch/pxad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 10/26/2023] [Indexed: 09/26/2023] Open
Abstract
Assessing enuresis involves distinguishing monosymptomatic from non-monosymptomatic for this common paediatric problem, and identifying concomitant comorbidities. Addressing co-occurring factors concurrently ensures the best opportunity for a satisfactory outcome. Treatment begins with patient and family education on the natural history of enuresis and practical behavioural guidance. Evidence to support particular interventions is limited, and children and families should be involved when choosing appropriate therapy. Enuresis alarms and desmopressin are treatment options when more active intervention is desired. Clinical refinements and combined treatment modalities are emerging.
Collapse
Affiliation(s)
- James Harris
- Canadian Paediatric Society, Community Paediatrics Committee, Ottawa, Ontario, Canada
| | - Alisa Lipson
- Canadian Paediatric Society, Community Paediatrics Committee, Ottawa, Ontario, Canada
| | - Joana Dos Santos
- Canadian Paediatric Society, Community Paediatrics Committee, Ottawa, Ontario, Canada
| |
Collapse
|
5
|
Huang WJ, Liang YY, Yang Q, Ma X. Nocturnal enuresis in children: Parents' perspectives. Nurs Open 2022; 9:2335-2341. [PMID: 35661439 PMCID: PMC9374395 DOI: 10.1002/nop2.1243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 04/21/2022] [Accepted: 05/06/2022] [Indexed: 02/05/2023] Open
Abstract
AIM Parents of children with nocturnal enuresis (NE) may have uncertainty and anxiety. This study aimed to investigate the level of uncertainty and anxiety in the parents of children with NE and analyse its influencing factors. DESIGN We conducted a descriptive cross-sectional study among the parents of children with NE in China. METHODS A general information questionnaire, the Parent Perception of Uncertainty Scale (PPUS), and the Self-Rating Anxiety Scale (SAS) were used. Multiple linear regression analysis was used to identify factors influencing the parental uncertainty level independently. RESULTS A total of 247 valid questionnaires were collected. The PPUS score of children with NE was 81.18 ± 10.82, and the anxiety self-rating scale score was 41.86 ± 9.20. Parents' working status, the family's per capita monthly income, and the children's treatment time were the main influencing factors of parental illness uncertainty.
Collapse
Affiliation(s)
- Wen-Jiao Huang
- West China School of Nursing/Department of Pediatric Surgery, Sichuan University, Chengdu, China
| | - Yuan-Yuan Liang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Yang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xue Ma
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
6
|
Jung HS. Review on herbal medicine versus desmopressin therapy for pediatric monosymptomatic enuresis. ADVANCES IN TRADITIONAL MEDICINE 2022. [DOI: 10.1007/s13596-021-00622-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
7
|
Arasteh A, Mostafavi S, Zununi Vahed S, Mostafavi Montazeri SS. An association between incontinence and antipsychotic drugs: A systematic review. Biomed Pharmacother 2021; 142:112027. [PMID: 34392083 DOI: 10.1016/j.biopha.2021.112027] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/06/2021] [Accepted: 08/07/2021] [Indexed: 11/29/2022] Open
Abstract
To date, due to the increasing prevalence of psychiatric diseases, the use of antipsychotic drugs has expanded. One of the proven side effects of these drugs is incontinence. Treatment of this complication improves the quality of life in these patients, increases self-confidence, and betters cope with their psychiatric illness. The exact mechanism of this side effect is not fully understood, but various methods have been used experimentally to deal with it. Strategies such as behavior therapy, discontinuation or change of drugs, reducing the dose of drugs, and adding drugs with less incontinence have been used. Each of these methods and studies has different results that need to be summarized to make optimal use of them. Since most of these reports are case reports with a low statistical population, our study has systematically reviewed these studies to find a comprehensive model to deal with this complication.
Collapse
Affiliation(s)
- Amin Arasteh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soroush Mostafavi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | |
Collapse
|
8
|
Balasubramanian A, Dang M, Yu J, Gerber JA, Seth A. Analysing online Twitter discussions of bedwetting via a condition-specific hashtag (#Bedwetting). J Paediatr Child Health 2021; 57:1215-1221. [PMID: 34008264 DOI: 10.1111/jpc.15428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 01/07/2021] [Accepted: 02/12/2021] [Indexed: 11/30/2022]
Abstract
AIM Bedwetting is a common paediatric condition. #Bedwetting has been established as the official hashtag to structure Twitter discussions about the condition. We analysed online Twitter discussions for #Bedwetting. METHODS Symplur, a Twitter analytics service was employed to aggregate Twitter activity, users and content including #Bedwetting, between October 2013 and November 2018. Activity was analysed via tweet volume and user adoption. Users were assorted using geographic location, occupation and affiliation data. Content in #Bedwetting Tweets was undertaken by retrieving information about retweets, links, frequently used words and hashtags. RESULTS A total of 101 412 tweets and 9957 users utilising #Bedwetting were identified. Most tweets were sent with links (93%). The average ± SD number of tweets using #Bedwetting per month increased from 96 ± 87 in 2013 to 2935 ± 1644 in 2015. Tweet volume decreased to 1960 ± 257 in 2016 and subsequently increased to 2901 ± 1110 in 2017. New users increased from 4 in 2013 to 9957 users in 2018. Users tweeted from 69 countries. Advocacy organisations comprised 35% of the top 100 influencers. Common words in #Bedwetting tweets were 'potty', 'best' and 'training'. Popular associated hashtags were #Pottytraining, #Solutions and #Moms. Hyperlinks in #Bedwetting tweets included advocacy, academic and commercial websites. CONCLUSIONS Our analysis of #Bedwetting highlights that Twitter is frequently used to discuss the condition's diagnosis and management. Various stakeholders in health care are utilising the platform to build awareness about bedwetting. We identified that Twitter is being employed to drive web traffic to other internet websites.
Collapse
Affiliation(s)
| | - Melissa Dang
- Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Justin Yu
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas, United States
| | - Jonathan A Gerber
- Department of Pediatric Urology, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, United States
| | - Abhishek Seth
- Department of Pediatric Urology, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, United States
| |
Collapse
|
9
|
Rakowska-Silska M, Jobs K, Paturej A, Kalicki B. Voiding Disorders in Pediatrician's Practice. CLINICAL MEDICINE INSIGHTS-PEDIATRICS 2020; 14:1179556520975035. [PMID: 33293883 PMCID: PMC7705800 DOI: 10.1177/1179556520975035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/22/2020] [Indexed: 01/23/2023]
Abstract
Voiding disorders result usually from functional disturbance. However, relevant
organic diseases must be excluded prior to diagnosis of functional disorders.
Additional tests, such as urinalysis or abdominal ultrasound are required.
Further diagnostics is necessary in the presence of alarm symptoms, such as
secondary nocturnal enuresis, weak or intermittent urine flow, systemic
symptoms, glucosuria, proteinuria, leukocyturia, erythrocyturia, skin lesions in
the lumbar region, altered sensations in the perineum. Functional micturition
disorders were thoroughly described in 2006, and revised in 2015 by ICCS
(International Children’s Continence Society) and are divided into storage
symptoms (increased and decreased voiding frequency, incontinence, urgency,
nocturia), voiding symptoms hesitancy, straining, weak stream, intermittency,
dysuria), and symptoms that cannot be assigned to any of the above groups
(voiding postponement, holding maneuvers, feeling of incomplete emptying,
urinary retention, post micturition dribble, spraying of the urinary stream).
Functional voiding disorders are frequently associated with constipation.
Bladder and bowel dysfunction (BBD) is diagnosed when lower urinary tract
symptoms are accompanied by problems with defecation. Monosymptomatic enuresis
is the most common voiding disorder encountered by pediatricians. It is
diagnosed in children older than 5 years without any other lower urinary tract
symptoms. Other types of voiding disorders such as: non-monosymptomatic
enuresis, overactive and underactive bladder, voiding postponement, bladder
outlet obstruction, stress or giggle incontinence, urethrovaginal reflux usually
require specialized diagnostics and therapy. Treatment of all types of
functional voiding disorders is based on non-pharmacological recommendations
(urotherapy), and such education should be implemented by primary care
pediatricians.
Collapse
Affiliation(s)
- Magda Rakowska-Silska
- Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland
| | - Katarzyna Jobs
- Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland
| | - Aleksandra Paturej
- Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland
| | - Bolesław Kalicki
- Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland
| |
Collapse
|
10
|
Kang BJ, Chung JM, Lee SD. Evaluation of Functional Bladder Capacity in Children with Nocturnal Enuresis According to Type and Treatment Outcome. Res Rep Urol 2020; 12:383-389. [PMID: 32984086 PMCID: PMC7501990 DOI: 10.2147/rru.s267417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 08/29/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to identify whether functional bladder capacity (FBC) differs among subgroups of nocturnal enuresis (NE) patients and can be used to predict treatment response. Methods A total of 69 children with NE were included in this study between July 2017 and February 2019 according to medical chart review, retrospectively. All patients completed a questionnaire about voiding symptoms and 48-hour frequency/volume (48-h F/V) charts. FBC was obtained from the 48-h F/V charts and uroflowmetry (UFM) with post-void residual volume (PVR). All patients were primarily treated with standard urotherapy and pharmacological therapy. The response rate was analyzed at 3 months after treatment. Results The mean age of the 69 patients (42 male, 27 female) was 83.3 ± 22.4 months (range, 5–13 years) at the first visit. The percentages of children with monosymptomatic NE (MNE) and non-monosymptomatic NE (NMNE) on the questionnaire were 40.6% (28/69) and 59.4% (41/69), respectively. FBC of all patients was lower than the normal range of expected bladder capacity, and there were no significant differences between measurement methods, NE types (MNE vs NMNE), or response rates (p > 0.05). Conclusion Children with NE had diminished FBC in both 48-h F/V charts and UFM with PVR. We found no difference in FBC by NE type or treatment outcome. Therefore, FBC cannot be used to distinguish between NE types or predict treatment responses.
Collapse
Affiliation(s)
- Byeong Jin Kang
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea.,Department of Urology, Pusan National University Hospital, Busan, Korea
| | - Jae Min Chung
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea.,Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sang Don Lee
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea.,Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| |
Collapse
|
11
|
Gasthuys E, Dossche L, Michelet R, Nørgaard JP, Devreese M, Croubels S, Vermeulen A, Van Bocxlaer J, Walle JV. Pediatric Pharmacology of Desmopressin in Children with Enuresis: A Comprehensive Review. Paediatr Drugs 2020; 22:369-383. [PMID: 32507959 DOI: 10.1007/s40272-020-00401-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Desmopressin is a synthetic analogue of the natural antidiuretic hormone arginine vasopressin. Over the years, it has been clinically used to manage nocturnal polyuria in children with enuresis. Various pharmaceutical formulations of desmopressin have been commercialized for this indication-nasal spray, nasal drops, oral tablet and oral lyophilizate. Despite the fact that desmopressin is a frequently prescribed drug in children, its use and posology is based on limited pediatric data. This review provides an overview of the current pediatric pharmacological data related to the different desmopressin formulations, including their pharmacokinetics, pharmacodynamics and adverse events. Regarding the pharmacokinetics, a profound food effect on the oral bioavailability was demonstrated as well as different plasma concentration-time profiles (double absorption peak) of the desmopressin lyophilizate between adults and children. Literature about maturational differences in distribution, metabolism and excretion of desmopressin is rather limited. Regarding the pharmacodynamics, formulation/dose/food effect and predictors of response were evaluated. The lyophilizate is the preferred formulation, but the claimed bioequivalence in adults (200 µg tablet and 120 µg lyophilizate), could not be readily extrapolated to children. Prescribing the standard flat-dose regimen to the entire pediatric population might be insufficient to attain response to desmopressin treatment, whereby dosing schemes based on age and weight were proposed. Moreover, response to desmopressin is variable, whereby complete-, partial- and non-responders are reported. Different reasons were enumerated that might explain the difference in response rate to desmopressin observed: different pathophysiological mechanisms, bladder capacity and other predictive factors (i.e. breast feeding, familial history, compliance, sex, etc.). Also, the relapse rate of desmopressin treatment was high, rendering it necessary to use a pragmatic approach for the treatment of enuresis, whereby careful consideration of the position of desmopressin within this treatment is required. Regarding the safety of the different desmopressin formulations, the use of desmopressin was generally considered safe, but additional measures should be taken to prevent severe hyponatremia. To conclude the review, to date, major knowledge gaps in pediatric pharmacological aspects of the different desmopressin formulations still remain. Additional information should be collected about the clinical relevance of the double absorption peak, the food effect, the bioequivalence/therapeutic equivalence, the pediatric adapted dosing regimens, the study endpoints and the difference between performing studies at daytime or at nighttime. To fill in these gaps, additional well designed pharmacokinetic and pharmacodynamic studies in children should be performed.
Collapse
Affiliation(s)
- Elke Gasthuys
- Department of Pediatric Nephrology, Faculty of Medicine and Health Sciences, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
- Health, Innovation and Research Institute, Faculty of Medicine and Health Sciences, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Kelchstr. 31, 12169, Berlin, Germany.
- Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium.
| | - Lien Dossche
- Department of Pediatric Nephrology, Faculty of Medicine and Health Sciences, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Robin Michelet
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Kelchstr. 31, 12169, Berlin, Germany
| | - Jens Peter Nørgaard
- Department of Pediatric Nephrology, Faculty of Medicine and Health Sciences, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Mathias Devreese
- Department of Pharmacology, Toxicology and Biochemistry, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium
| | - Siska Croubels
- Department of Pharmacology, Toxicology and Biochemistry, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium
| | - An Vermeulen
- Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium
| | - Jan Van Bocxlaer
- Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium
| | - Johan Vande Walle
- Department of Pediatric Nephrology, Faculty of Medicine and Health Sciences, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| |
Collapse
|
12
|
|
13
|
Kaya Aksoy G, Semerci Koyun N, Doğan ÇS. Does smoking exposure affect response to treatment in children with primary monosymptomatic nocturnal enuresis? J Pediatr Urol 2020; 16:47.e1-47.e6. [PMID: 31735520 DOI: 10.1016/j.jpurol.2019.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 10/14/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND There are many variables affecting the success of treatment in children with primary monosymptomatic nocturnal enuresis (PMNE). This study investigates the possible effect of cigarette smoke exposure on desmopressin treatment response in children with PMNE. METHOD The medical records of pediatric patients with PMNE between February 2018 and December 2018 were retrospectively reviewed. Those who had moderate (3-5 wet nights/week) and severe (>5 wet nights/week) PMNE were included in the study. All patients received 120 mcg of sublingual desmopressin. After 3 months of therapy, treatment response was classified as complete response (100% dry night), partial response (between 50% and 99%) and non-responsiveness (<49% improvement). Partial response or non-responsiveness is considered as treatment failure. The relationship between treatment response to desmopressin and exposure to cigarette smoke was evaluated. Moreover, the other risk factors for treatment failure were investigated. RESULTS A total of 81 children with the diagnosis of PMNE, with a mean age of 9.98 ± 2.62 years, were included in the study. The frequency of passive smoke exposure at home was 53.1%. Sixty-two patients (76.5%) had severe PMNE, and the response to desmopressin decreased with severity of symptoms. Non-responsiveness to treatment, partial response, and complete response were observed in 11 (13.6%), 23 (28.4%), and 47 (58.0%) of patients, respectively. Treatment failure (n = 34, 42%) was 55.8% in children exposed to smoke and 26.4% in those who were not (p = 0.001). Although univariate analysis revealed that the severity of symptoms and smoke exposure were associated with treatment failure, in multivariate analysis, the presence of smoke exposure was the only independent risk factor (OR = 3.214, 95% CI: 0.125-0.888; p = 0.024) (Summary Table 1). CONCLUSION Exposure to cigarette smoke is a changeable and important risk factor that reduces the success of desmopressin treatment in children with PMNE.
Collapse
Affiliation(s)
- Gülşah Kaya Aksoy
- University of Health Sciences, Antalya Training and Research Hospital, Turkey.
| | - Nevin Semerci Koyun
- University of Health Sciences, Antalya Training and Research Hospital, Turkey
| | - Çağla Serpil Doğan
- University of Health Sciences, Antalya Training and Research Hospital, Turkey
| |
Collapse
|
14
|
Bogaert G, Stein R, Undre S, Nijman RJM, Quadackers J, 't Hoen L, Kocvara R, Silay S, Tekgul S, Radmayr C, Dogan HS. Practical recommendations of the EAU-ESPU guidelines committee for monosymptomatic enuresis-Bedwetting. Neurourol Urodyn 2019; 39:489-497. [PMID: 31793066 DOI: 10.1002/nau.24239] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/14/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND AIMS The objective of this update of the EAU-ESPU guidelines recommendations for nocturnal enuresis was to review the recent published literature of studies, reviews, guidelines regarding the etiology, diagnosis and treatment options of nocturnal enuresis and transform the information into a practical recommendation strategy for the general practitioner, pediatrician, pediatric urologist and urologist. MATERIAL AND METHODS Since 2012 a monthly literature search using Scopus® was performed and the relevant literature was reviewed and prospectively registered on the European Urology bedwetting enuresis resource center (http://bedwetting.europeanurology.com/). In addition, guideline papers and statements of the European Society for Paediatric Urology (ESPU), the European Association of Urology (EAU), the National Institute for Health and Care Excellence (NICE) and the International Children Continence Society (ICCS) were used to update the knowledge and evidence resulting in this practical recommendation strategy. Recommendations have been discussed and agreed within the working group of the EAU-ESPU guidelines committee members. RESULTS The recommendations focus to place the child and his family in a control position. Pragmatic analysis is made of the bedwetting problem by collecting voiding and drinking habits during the day, measuring nighttime urine production and identification of possible risk factors such as high-volume evening drinking, nighttime overactive bladder, behavioral or psychological problems or sleep disordered breathing. A questionnaire will help to identify those risk factors. CONCLUSION Motivation of the child is important for success. Continuous involvement of the child and the family in the treatment will improve treatment compliance, success and patient satisfaction.
Collapse
Affiliation(s)
- Guy Bogaert
- Department of Urology, University of Leuven, Leuven, Belgium
| | - Raimund Stein
- Department of Pediatric, Adolescent and Reconstructive Urology, Medical Faculty Mannheim, University of Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Shabnam Undre
- Department of Pediatric and Adult Urology, East and North Herts NHS Trust, Stevenage, UK
| | - Rien J M Nijman
- Department of Urology and Pediatric Urology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Josine Quadackers
- Department of Urology and Pediatric Urology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Lisette 't Hoen
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Radim Kocvara
- Department of Urology, First Faculty of Medicine in Praha, General Teaching Hospital, Charles University, Prague, Czech Republic
| | - Selcuk Silay
- Division of Pediatric Urology, Department of Urology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Serdar Tekgul
- Division of Pediatric Urology, Department of Urology, Hacettepe University, Ankara, Turkey
| | - Christian Radmayr
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Hasan Serkan Dogan
- Division of Pediatric Urology, Department of Urology, Hacettepe University, Ankara, Turkey
| |
Collapse
|
15
|
Bastos JM, Rondon AV, de Lima GRM, Zerati M, Schneider-Monteiro ED, Molina CAF, Calado ADA, Barroso U. Brazilian consensus in enuresis-recomendations for clinical practice. Int Braz J Urol 2019; 45:889-900. [PMID: 31408290 PMCID: PMC6844333 DOI: 10.1590/s1677-5538.ibju.2019.0080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/06/2019] [Indexed: 01/14/2023] Open
Abstract
Introduction Enuresis, defined as an intermittent urinary incontinence that occurs during sleep, is a frequent condition, occurring in about 10% of children at 7 years of age. However, it is frequently neglected by the family and by the primary care provider, leaving many of those children without treatment. Despite of many studies in Enuresis and recent advances in scientific and technological knowledge there is still considerable heterogeneity in evaluation methods and therapeutic approaches. Materials and Methods The board of Pediatric Urology of the Brazilian Society of Urology joined a group of experts and reviewed all important issues on Enuresis and elaborated a draft of the document. On September 2018 the panel met to review, discuss and write a consensus document. Results and Discussion Enuresis is a multifactorial disease that can lead to a diversity of problems for the child and family. Children presenting with Enuresis require careful evaluation and treatment to avoid future psychological and behavioral problems. The panel addressed recommendations on up to date choice of diagnosis evaluation and therapies.
Collapse
Affiliation(s)
- José Murillo Bastos
- Universidade Federal de Juiz de Fora (UFJF) e Hospital e Maternidade Therezinha de Jesus da Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (HMTJ-SUPREMA), Juiz de Fora, MG, Brasil
| | - Atila Victal Rondon
- Universidade do Estado do Rio de Janeiro (UERJ) e Hospital Federal Cardoso Fontes (HFCF), Rio de Janeiro, RJ, Brasil
| | | | - Miguel Zerati
- Instituto de Urologia e Nefrologia de São José do Rio Preto (IUN) e Faculdade Regional de Medicina(FAMERP), Hospital de Base, São José do Rio Preto, SP, Brasil
| | | | - Carlos Augusto F Molina
- Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brasil
| | | | - Ubirajara Barroso
- Universidade Federal da Bahia (UFBA) e Escola Bahiana de Medicina (BAHIANA), Salvador, BA, Brasil
| |
Collapse
|
16
|
Wu G, Liu J, Yue X. Prediction of drug-disease associations based on ensemble meta paths and singular value decomposition. BMC Bioinformatics 2019; 20:134. [PMID: 30925858 PMCID: PMC6439991 DOI: 10.1186/s12859-019-2644-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background In the field of drug repositioning, it is assumed that similar drugs may treat similar diseases, therefore many existing computational methods need to compute the similarities of drugs and diseases. However, the calculation of similarity depends on the adopted measure and the available features, which may lead that the similarity scores vary dramatically from one to another, and it will not work when facing the incomplete data. Besides, supervised learning based methods usually need both positive and negative samples to train the prediction models, whereas in drug-disease pairs data there are only some verified interactions (positive samples) and a lot of unlabeled pairs. To train the models, many methods simply treat the unlabeled samples as negative ones, which may introduce artificial noises. Herein, we propose a method to predict drug-disease associations without the need of similarity information, and select more likely negative samples. Results In the proposed EMP-SVD (Ensemble Meta Paths and Singular Value Decomposition), we introduce five meta paths corresponding to different kinds of interaction data, and for each meta path we generate a commuting matrix. Every matrix is factorized into two low rank matrices by SVD which are used for the latent features of drugs and diseases respectively. The features are combined to represent drug-disease pairs. We build a base classifier via Random Forest for each meta path and five base classifiers are combined as the final ensemble classifier. In order to train out a more reliable prediction model, we select more likely negative ones from unlabeled samples under the assumption that non-associated drug and disease pair have no common interacted proteins. The experiments have shown that the proposed EMP-SVD method outperforms several state-of-the-art approaches. Case studies by literature investigation have found that the proposed EMP-SVD can mine out many drug-disease associations, which implies the practicality of EMP-SVD. Conclusions The proposed EMP-SVD can integrate the interaction data among drugs, proteins and diseases, and predict the drug-disease associations without the need of similarity information. At the same time, the strategy of selecting more reliable negative samples will benefit the prediction.
Collapse
Affiliation(s)
- Guangsheng Wu
- School of Computer Science, Wuhan University, Wuhan, 430072, People's Republic of China
| | - Juan Liu
- School of Computer Science, Wuhan University, Wuhan, 430072, People's Republic of China. .,Suzhou Institute of Wuhan University, Suzhou, 215123, People's Republic of China.
| | - Xiang Yue
- School of Computer Science, Wuhan University, Wuhan, 430072, People's Republic of China.,Department of Computer Science and Engineering, The Ohio State University, Ohio, 43210, USA
| |
Collapse
|
17
|
Maternik M. Understanding of and misconceptions around monosymptomatic nocturnal enuresis: findings from patient and physician surveys. J Pediatr Urol 2019; 15:37.e1-37.e8. [PMID: 30340929 DOI: 10.1016/j.jpurol.2018.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 09/18/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Monosymptomatic nocturnal enuresis (MNE) is a common paediatric condition, caused by the interaction of multiple physiological mechanisms. The condition can lead to psychiatric comorbidities that are detrimental to quality of life but is under-recognised and misunderstood by society and healthcare providers. OBJECTIVE The objective of this study was to gather information from non-specialist physicians on their understanding of enuresis in selected European countries and from patients about the prevalence of MNE, its relationship with comorbidities and the burden of the condition. MATERIALS AND METHODS Between June 2016 and March 2017, physicians and patients in Alpe-Adria, Italy, Romania, Russia, Serbia and Slovakia were asked to complete different surveys on their understanding of the medical condition, its impact on the lives of patients and the prevalence of comorbidities. Surveys were translated into local languages. Survey responses were collated, and data were presented descriptively. RESULTS Overall, 261 physicians (paediatricians comprising nearly two-thirds) and 340 patients (approximately two-thirds were male) completed their respective surveys. Most physicians (67%) believed MNE to be caused by circadian variation of antidiuretic hormone but also mentioned psychological factors as a cause (48%). The most common explanation for MNE given by patients was psychological factors (26%), but 17% gave no explanation. For patients, difficulties related to enuresis were often behavioural (77%), including difficulties at school (61%) and with sleeping (40%). Physicians perceived low self-esteem (32%), anxiety (24%) and embarrassment (17%) as having the greatest impact on patients. There was disagreement among physicians about which discipline is best placed to treat MNE. Favoured treatments were not necessarily consistent with evidence-based guidelines, with lifestyle changes and pharmacological interventions cited most frequently. DISCUSSION The findings of these complementary surveys illustrate that the causes and best treatment of MNE are subject to misconceptions on the part of both the physician and the patient's caregiver. Overall, MNE is perceived as a psychological condition, rather than having a multifactorial pathophysiological basis with a substantial psychological impact. Educational initiatives for healthcare practitioners and the public should help to optimise the understanding of MNE and care of patients.
Collapse
Affiliation(s)
- M Maternik
- Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, Dębinki 7, 80-211, Gdansk, Poland.
| |
Collapse
|
18
|
Primary Nocturnal Enuresis: A Novel Therapeutic Strategy With Higher Efficacy. Urology 2019; 124:241-247. [DOI: 10.1016/j.urology.2018.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/07/2018] [Accepted: 09/15/2018] [Indexed: 01/28/2023]
|
19
|
Dane S, Welcome MO. A case study: Effects of foot reflexotherapy on ADHD symptoms and enuresis nocturia in a child with ADHD and enuresis nocturia. Complement Ther Clin Pract 2018; 33:139-141. [PMID: 30396612 DOI: 10.1016/j.ctcp.2018.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/22/2018] [Accepted: 10/04/2018] [Indexed: 10/28/2022]
|
20
|
Abstract
Enuresis is a frequent complaint not always volunteered by parents or patients. The pediatric clinician has to inquire about enuresis to break the secrecy surrounding this symptom that could be related to a more serious underlying renal, endocrine, or psychosocial disease. Determining the type of enuresis is crucial to offer optimal treatment. We present a review for the pediatric clinician to optimize their care of the child with monosymptomatic enuresis. [Pediatr Ann. 2018;47(10):e390-e395.].
Collapse
|