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World J Nephrol. Jul 6, 2016; 5(4): 328-338
Published online Jul 6, 2016. doi: 10.5527/wjn.v5.i4.328
Management of nocturnal enuresis - myths and facts
Rajiv Sinha, Sumantra Raut
Rajiv Sinha, Paediatric Nephrology, Department of Pediatrics, Institute of Child Health, Kolkata 700017, West Bengal, India
Sumantra Raut, Department of Pediatrics, Medical College, Kolkata 700075, West Bengal, India
Author contributions: Sinha R designed the paper; Sinha R and Raut S performed the search; Sinha R and Raut S wrote the paper.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Rajiv Sinha, MD, MNAMS, FRCPCH (UK), Associate Professor of Pediatrics, Department of Pediatrics, Institute of Child Health, 11 Biresh Guha Street, Kolkata 700017, West Bengal, India. rajivsinha_in@yahoo.com
Telephone: +91-33-22801525
Received: December 28, 2015
Peer-review started: January 1, 2016
First decision: February 29, 2016
Revised: April 6, 2016
Accepted: May 10, 2016
Article in press: May 11, 2016
Published online: July 6, 2016
Processing time: 183 Days and 21.2 Hours
Abstract

Nocturnal enuresis often causes considerable distress or functional impairment to patient and their parents necessitating a multidisciplinary approach from paediatrician, paediatric nephrologist, urologists and psychiatrist. Mechanisms of monosymptomatic nocturnal enuresis are mainly nocturnal polyuria, bladder overactivity and failure to awaken from sleep in response to bladder sensations. Goal oriented and etiology wise treatment includes simple behavioral intervention, conditioning alarm regimen and pharmacotherapy with desmopressin, imipramine and anticholinergic drugs. Symptoms often recurs requiring change over or combination of different modes of

treatment.

Keywords: Nocturnal enuresis; Monosymptomatic; Conditioning alarm; Desmopressin; Imipramine

Core tip: Nocturnal enuresis often causes considerable distress to patient and their parents’ lifestyle necessitating a multidisciplinary management. Simple behavioral interventions, conditioning alarm regimen and pharmacotherapy as desmopressin, imipramine and anticholinergic drugs are the mainstay of therapy used as per underlying etiology or parents’ concern. Therapy should be structured and goal directed to reduce recurrence.