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

OBJECTIVE: To study the cognitive neural mechanism of working memory impairment in children with primary nocturnal enuresis using event-related potential (ERP). METHODS: A total of 14 children with primary nocturnal enuresis were enrolled as enuresis group, and 14 normal children were enrolled as control group. The learning-recognition task test was applied, and the ERP components (P2, N2, and P3) at Fz lead while identifying old pictures (learned) and new ones (unlearned) were measured and compared between the two groups. RESULTS: While identifying the old pictures, the enuresis group had a lower amplitude of P2 and N2 than the control group (P<0.05). There were no significant differences between the two groups in the latency of P2, N2, and P3 and the amplitude of P3. While identifying the new pictures, the enuresis group had a longer latency of P2 and a significantly lower amplitude of N2 than the control group (P<0.05). There were no significant differences between the two groups in the amplitude of P2 and P3 and the latency of N2 and P3. CONCLUSIONS Compared with normal children, the children with primary nocturnal enuresis have reduced abilities of classified information extraction, a prolonged reaction time, and reductions in memory capacity, memory consolidation, and conflict monitoring, which causes working memory impairment.
Child ; Electroencephalography ; Evoked Potentials ; Evoked Potentials, Auditory ; Humans ; Memory Disorders ; Memory, Short-Term ; Nocturnal Enuresis ; Reaction Time

PURPOSE: To characterize the course of treatment for nonmonosymptomatic enuresis with overactive bladder (OAB) in a real clinical setting. METHODS: Data from 111 OAB patients with moderate to severe enuresis were analyzed. The baseline analysis included a questionnaire, voiding diary, uroflowmetry with postvoid residual urine measurement, and plain abdominal radiography of the kidneys, ureters, and bladder (KUB). Following standard urotherapy for 1 month, anticholinergic medication was administered with or without laxatives. Desmopressin was added if there was a partial response to OAB. Patients were followed every 3 months to evaluate the status of OAB and enuresis. Multivariate analysis was performed to identify predictors associated with the lack of complete response (CR) in enuresis at 12 months. RESULTS: Following 12 months of treatment, 64% and 88% of patients experienced at least partial response in enuresis and OAB, respectively. Urgency improved more quickly than enuresis, supporting the need to address daytime symptoms before enuresis. Seventy-nine patients (71%) had fecal impaction on KUB and/or subjective constipation. The combination of anticholinergics with either laxatives or desmopressin fared better than anticholinergics alone. Daytime incontinence and anticholinergics-only treatment were associated with a lack of CR during 12 months of treatment. CONCLUSIONS: The data confirmed the validity of addressing OAB before treating enuresis. The results of this study also highlight the need to address fecal impaction. Patients should be counseled about the need for a prolonged course of treatment before starting treatment. Anticholinergics should be accompanied with either desmopressin or laxatives for better control of enuresis.
Cholinergic Antagonists ; Constipation ; Deamino Arginine Vasopressin ; Enuresis* ; Fecal Impaction ; Humans ; Kidney ; Laxatives ; Multivariate Analysis ; Radiography, Abdominal ; Ureter ; Urinary Bladder ; Urinary Bladder, Overactive*

PURPOSE: To compare the effects of intra-anal biofeedback (BF) and intra-anal electrical stimulation (ES) on pelvic floor muscles (PFMs) activity, nocturnal bladder capacity, and frequency of wet night episodes in children with refractory primary monosymptomatic nocturnal enuresis (PMNE). METHODS: Ninety children of both sexes aged 8–12 years with refractory PMNE participated in this study. They were randomly assigned to 3 groups of equal number: control group (CON) that underwent behavioral therapy and PFM training, and 2 study groups (BF and ES) that underwent the same program in addition to intra-anal BF training and intra-anal ES, respectively. PFMs activity was assessed using electromyography, nocturnal bladder capacity was evaluated by measuring the first morning voided volume, and a nocturnal enuresis diary was used for documenting wet night episodes before treatment and after 3 months of treatment. RESULTS: After training, all groups showed statistically significant improvements in all measured outcomes compared to their pretreatment findings. The ES group showed significantly greater improvements in all measured outcomes than the CON and BF groups. CONCLUSIONS: Both intra-anal BF training and ES combined with behavioral therapy and PFMs training were effective in the treatment of PMNE, with intra-anal ES being superior to BF training.
Biofeedback, Psychology* ; Child* ; Electric Stimulation* ; Electromyography ; Humans ; Muscles ; Nocturnal Enuresis* ; Pelvic Floor ; Urinary Bladder

A 54-year-old man presented with change in behaviour, nocturnal enuresis, abnormal limb movement and headache of one week's duration. The diagnosis of butterfly glioma (glioblastoma multiforme) was made based on imaging characteristics and was further confirmed by biopsy findings. As the corpus callosum is usually resistant to infiltration by tumours, a mass that involves and crosses the corpus callosum is suggestive of an aggressive neoplasm. Other neoplastic and non-neoplastic conditions that may involve the corpus callosum and mimic a butterfly glioma, as well as associated imaging features, are discussed.
Aged ; Biopsy ; Brain Neoplasms ; diagnostic imaging ; Corpus Callosum ; diagnostic imaging ; Glioblastoma ; diagnostic imaging ; Headache ; physiopathology ; Humans ; Male ; Middle Aged ; Movement Disorders ; physiopathology ; Nocturnal Enuresis ; physiopathology

Nocturnal enuresis is a common problem of children during sleeping at preschool or school age. It may affect negatively the psychosocial development of children. Children with enuresis may have lower self-esteem and lower quality of life. There are three main factors of the pathophysiology of enuresis: high nocturnal urine production, nocturnal low bladder capacity or increased detrusor muscle activity, and arousal disorder. As pharmacological therapy for nocturnal enuresis, several medications including desmopressin, anticholinergics, imipramine have been used for a long time. As first-line therapy, desmopressin combined with anticholinergics has good response in primary monosymptomatic nocturnal enuresis. Because imipramine has serious and lethal cardiotoxic effect with overdosage, imipramine should be prescribed after EKG to rule out the conduction problem of heart.
Arousal ; Child ; Cholinergic Antagonists ; Deamino Arginine Vasopressin ; Electrocardiography ; Enuresis ; Heart ; Humans ; Imipramine ; Nocturnal Enuresis* ; Quality of Life ; Urinary Bladder

Behavioral therapy refers to a broad range of treatment modalities that regulate the child's behavior to induce a therapeutic effect on nocturnal enuresis. Simple behavioral therapies include fluid restriction, lifting, waking, introducing reward systems, and bladder training. Simple behavioral therapy is significantly less effective than an enuresis alarm or desmopressin. If a child needs treatment, an enuresis alarm or desmopressin should not be delayed. Enuresis alarms are an effective form of treatment, although they require active involvement of the health care provider to reduce the likelihood of dropout and to motivate the child and parents.
Behavior Therapy ; Child ; Deamino Arginine Vasopressin ; Enuresis* ; Health Personnel ; Humans ; Lifting ; Nocturnal Enuresis ; Parents ; Reward ; Urinary Bladder

No abstract available.
Nocturnal Enuresis*

There are two types of refractory nocturnal enuresis. The first type corresponds to patients who are refractory from initial success, and the second type refers to refractory nocturnal enuresis after long-term success, in patients who cannot discontinue medications for enuresis. In the former type, it is necessary to determine whether the timing of medications is appropriate, whether the usage of antidiuretics is appropriate, whether any lifestyle changes have taken place, and whether there are secondary causes of enuresis. In the latter type, enuretic alarm treatment should be considered initially, and it is then important to investigate whether a respiratory obstruction is present in patients with nocturnal polyuria, whether the patient is constipated, and whether patients with non-monosymptomatic nocturnal enuresis have lower urinary tract symptoms or attention deficit hyperactivity disorder.
Attention Deficit Disorder with Hyperactivity ; Drug Resistance ; Drug Therapy ; Enuresis ; Humans ; Life Style ; Lower Urinary Tract Symptoms ; Nocturnal Enuresis* ; Polyuria

PURPOSE: This study aims to evaluate and compare the efficacy of exogenous melatonin associated with desmopressin (dDAVP) and dietary recommendations. METHODS: A total of 189 patients were enrolled from the Service of Pediatrics, Campus Bio-Medico University Hospital of Rome, from January 2013 to June 2015. Of the 189 original patients, 153 children, aged between 5 and 14 years (mean age, 8.7 years) were included in the study. After clinical evaluation and a 3-month period of observation without treatment, children were assigned to receive treatment in one of 3 groups: group 1, dDAVP at a dose of 120 mcg a day (Minirin); group 2, dDAVP at a dose of 120 mcg and dietary recommendations; or group 3, dDAVP at a dose of 120 mcg, dietary recommendations, and melatonin at a dose of 1 mg a day (Melamil plus). Each patient was treated for 3 months. RESULTS: After the 3 months of therapy, a desiderable response was achieved in 30 of 51 patients (58.82%) treated with dDAVP, 35 of 53 patients (66.04%) treated with dDAVP and dietary recommendations, and 35 of 49 patients (71.43%) treated with dDAVP, dietary recommendations, and melatonin. CONCLUSIONS: Although not statistically significant, the results show that the association between dDAVP treatment with dietary recommendations and melatonin could be considered a safe and effective treatment of NE. Considering that the statistically insignificant results might be due to the small sample size, the study will be continued to increase the number of subjects.
Child ; Deamino Arginine Vasopressin* ; Enuresis* ; Humans ; Melatonin ; Pediatrics ; Sample Size