No abstract available.
Nocturnal Enuresis*

No abstract available.
Nocturnal Enuresis*

Nocturnal enuresis has been recognized as an adverse effect of clozapine treatment. We reported 3 chronic schizophrenic patients who had showed nocturnal enuresis following clozapine treatment. Oxybutynin hydrochloride on clozapine-induced enuresis was very effective in 3 patients. The dose in our patients was 5 to 10mg/day. This medication was well tolerated. It is suggested that oxybutynin hydrochloride is a effective therapeutic option in clozapine-induced nocturnal enuresis.
Clozapine* ; Enuresis ; Humans ; Nocturnal Enuresis* ; Schizophrenia

The treatment of choice for primary nocturnal enuresis (PNE) in Korea remains imipramine which has proven to be effective in approximately 50 to 80%, but it is an antidepressant with toxic side effects and risk of overdose. Recently desmopressin (DDAVP, 1-desamino-8-Darginine-vasopressin) has been introduced for the treatment and its effect has been promising in many reports. To find the efficacy and safety of intranasal desmopressin, we evaluated the results of therapy in 48 enuretic children (34 boys and 14 girls). Mean age was 9.8 years (range 5-16). All the children were evaluated at least 3 months after the treatment with intranasal desmopressin. The overall response rate was 83.3%. The number of wet night per week before and after intranasal desmopressin treatment was 6.42 and 1.83 nights per week respectively. No side effects were observed. These data shows that the intranasal desmopressin therapy is effective and safe for the treatment of PNE.
Child ; Deamino Arginine Vasopressin* ; Enuresis ; Humans ; Imipramine ; Korea ; Nocturnal Enuresis*

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.
Child ; Enuresis ; Humans ; Incidence ; Nocturnal Enuresis ; Osmolar Concentration ; Urinary Bladder

BACKGROUND: We examined the usefulness of urine osmolality, as a predictive factor in the treatment of monosymptomatic nocturnal enuresis (NE) with combination therapy of imipramine and desmopressin. METHODS: From May 2014 to April 2015, 59 monosymptomatic NE patients participated in this study. Early morning urine osmolality was measured at 1 week and 1 day before combination therapy of imipramine and desmopressin, and at 1 week and 2 weeks after therapy. The response to combination therapy was evaluated at 3 months after treatment. The mean period of combination therapy was 6.4+/-4.2 weeks. Therapeutic response was classified as complete (0-1 wet night/week), partial (over 50% reduction of night) and non-responders (less than 50% reduction of night). RESULTS: The cumulative rate of the complete and partial responders was 76.3%. Among the 3 groups, the statistically lowest value of pre-treatment urine osmolality was observed in the complete responder group (p<0.001). Urine osmolality increased in all groups after treatment, however, statistically the greatest difference between pre and post-treatment urine osmolality was observed in the complete responder group (p=0.024). No serious side effects were observed. CONCLUSION: Early morning urine osmolality and change of urine osmolality between pre and post-treatment have predictive values in the response to combined imipramine and desmopressin for treatment of monosymptomatic NE.
Deamino Arginine Vasopressin* ; Enuresis ; Humans ; Imipramine* ; Nocturnal Enuresis* ; Osmolar Concentration*

PURPOSE: The aim of this study, to investigate whether there is any association between enuresis in childhood and nocturnal polyuria syndrome (NPS) in adult life. METHODS: The study consisted of thirty five patients with nocturnal polyuria, and thirty five healthy people without nocturnal polyuria in adult life, were asked to assess their enuresis in childhood. RESULTS: There was a history of enuresis in childhood in 18 (51.42%) of 35 of men with nocturnal polyuria and in 4 (11.42%) of 35 without nocturnal polyuria. Enuresis in childhood was significantly more common in men with nocturnal polyuria than without nocturnal polyuria. The difference was significant (P<0.0001). The prevalence of enuresis in the nocturnal polyuria (51.42%) was more than two-fold higher than reported prevalence in general populations. CONCLUSIONS: The results of this study suggest that the history of enuresis in childhood seems to increase the risk of having NPS in adult life. This relationship should be taken into account in the evaluation of men with complaints from NPS in adult life and the possible common pathophysiology should be considered in the treatment planning.
Adult ; Child ; Enuresis ; Humans ; Male ; Nocturnal Enuresis ; Polyuria ; Prevalence

Humans ; Magnetic Resonance Imaging ; Nocturnal Enuresis/diagnostic imaging*

PURPOSE: Hypercalciuria has been suggested to be involved in the pathogenesis of nocturnal enuresis associated with polyuria. We have measured the amount of calcium excretion in the urine from children with monosymptomatic nocturnal enuresis and studied the association with enuresis. METHODS: Thirty-six children (20 males and 16 females, age 5 to 15.6 years) presenting with monosymptomatic nocturnal enuresis were recruited for this study. RESULTS: Among 36 patients, 6 patients had hypercalciuria, providing a 16.7% frequency. The mean Ca/Cr ratio of hypercalciuria group showed 0.23+/-0.10 on daytime, and 0.33+/-0.10 on nighttime showing higher values in nighttime, but it was not statistically significant. Average 24 hour calcium excretion was 8.95 mg/kg. Night/day time urine volume ratio in hypercalciuria group was 0.87+/-0.20, and that in normocalciuria group was 0.81+/-0.33, also showing no difference. Daytime Ca/Cr ratio and nighttime Ca/Cr ratio from all enuresis patients showed a significant correlation (P=0.0001). However, Ca/Cr ratio between daytime and nighttime urine volume had no significant correlation, respectively (daytime P=0.08; nighttime P=0.07). Also, daytime and nighttime Na concentration, urea concentration, and osmolality also had no significant correlation with urine Ca/Cr ratio, respectively. CONCLUSION: Hypercalciuria shown in some of enuresis patients is not directly caused by primary monosymptomatic nocturnal enuresis.
Calcium ; Child ; Enuresis ; Female ; Humans ; Hypercalciuria ; Male ; Nocturnal Enuresis ; Osmolar Concentration ; Polyuria ; Urea

PURPOSE: Pharmacotherapy is the mainstay in the treatment of patients with primary nocturnal enuresis. However, as effective as it may be, the high relapse rate after the discontinuation of medicine remains difficult to overcome. Modulation of the duration or discontinuation method of medication was investigated to see if this could reduce the relapse rate. MATERIALS AND METHODS: Between May 1998 and December 2003, 87 boys and 46 girls (mean age 7.8, range 5-15 year-old) were included in this study. The criteria for inclusion were the enuresis had to be primary and uncomplicated, showing a good and early response to pharmacotherapy, resulting in 90% dry nights within 1 month from the beginning of medication. Patients were treated with desmopressin only and followed up for at least 3 months after discontinuation of medicine. Patients were divided into 4 groups, 3 month medication, 3 month medication with tapered dose reduction, 6 month medication and 6 month medication with tapered dose reduction group. Medication was tapered by reducing the dosage by half every 2 weeks, within a maximum of 2 months. Relapse was defined as the occurrence of more than 4 episodes of enuresis per month. There were no differences in age, sex, frequencies of enuresis before and after the medication between the four groups. RESULTS: The relapse rate was 54.4% in patients with primary nocturnal enuresis. The rates for relapse were 75.9 and 46.3% in patients with 3 and 6 months of medication, respectively (p<0.001). With respect to the method for reducing the medication dosage, there was a significant difference in the relapse rate between the sudden stop and tapered dose groups, which were 71.3 and 46.2%, respectively (p=0.006). However, there were no significant differences in the relapse rates with respect to the methods for reducing the medication for the same period. CONCLUSIONS: Gradual dosage reduction for the discontinuation of medicine has a beneficial effect in reducing the relapse rate. For best results, long-term medication with a tapered dose reduction is recommended.
Child* ; Deamino Arginine Vasopressin ; Drug Therapy ; Enuresis* ; Female ; Humans ; Nocturnal Enuresis* ; Recurrence*