Secondary nocturnal enuresis accounts for about one quarter of patients with bedwetting. Although a psychological cause is responsible in some children, various other causes are possible and should be considered. This article reviews the epidemiology, psychological and social impact, causes, investigation, management, and prognosis of secondary nocturnal enuresis.
Get full access to this article
View all access options for this article.
References
1.
1. Nørgaard JP, van Gool JD, Hjãlmås K, et al. Standardization and definitions in lower urinary tract dysfunction in children. Br J Urol. 1998; 81: 1-16.
2.
2. Fergusson DM, Horwood LJ, Shannon FT. Secondary enuresis in a birth cohort of New Zealand children. Paediatr Perinat Epidemol. 1990; 4: 53-63.
3.
3. Forsythe WI, Redmond A. Enuresis and spontaneous cure rate: study of 1,129 enuretics. Arch Dis Child. 1974; 49: 259-263.
4.
4. Järvelin MR, Moilanen I, Kangas P, et al. Aetiological and precipitating factors for childhood enuresis. Acta Paedatr Scand. 1991; 80: 361-369.
5.
5. von Gontard A, Hollmann E, Eiberg H, et al. Clinical enuresis phenotypes in familial nocturnal enuresis. Scand J Urol Nephrol. 1997;183(suppl):11-16.
6.
6. McGee R, Makinson T, Williams S, et al. A longitudinal study of enuresis from five to nine years. Aust Paediatr. 1984; 20: 39-42.
7.
7. Morison MJ. Parents' and young people's attitudes towards bedwetting and their influence on behaviour, including readiness to engage in and persist with treatment. Br J Urol.1998; 81: 56-66.
8.
8. Van Tijen NM, Messer AP, Namdar Z. Perceived stress of nocturnal enuresis in childhood. Br J Urol. 1998; 81: 98-99.
9.
9. Haque M, Ellerstein NS, Gundy JH, et al. Parental perceptions of enuresis: a collaborative study. Am J Dis Child. 1981;135:809-811.
11. Hagglöf B, Andren O, Bergstrm E, et al. Self-esteem before and after treatment in children with nocturnal enuresis and urinary incontinence. Scand J Urol Nephrol. 1997; 31: 79-82.
12.
12. Nörgaard JP, Djurhuus JC, Watanabe H, et al. Experience and current status of research into the pathophysiology of nocturnal enuresis. Br J Urol. 1997; 79: 825-835.
13.
13. Robson WLM. Enuresis. Adv Pediatr (in press).
14.
14. Wolfish NM. Sleep arousal function in enuretic males. Scand J Urol Nephrol. 1999; 33: 24-26.
16. Van Gool JD, de Jonge GA. Urge syndrome and urge incontinence. Arch Dis Child. 1989; 64: 1629-1634.
17.
17. Fernandes E, Vernier R, Gonzalez R. The unstable bladder in children. J Pediatr.1991;118:831-837.
18.
18. Travis LB. Evaluating the child with enuresis. In: Rudolph AM, Hoffman JI, Rudolph CD, eds. Rudolph's Pediatrics. Stamford, CT: Appleton and Lange; 1996:1336-1337.
19.
19. Loening-Baucke V. Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood. Pediatrics. 1997; 100: 228-232.
20.
20. von Gontard A, Mauer-Mucke K, Plfick J, et al. Clinical behavioral problems in dayand night-wetting children. Pediatr Nephrol. 1999; 13: 662-667.
21.
21. Feehan M, McGee R, Stanton W, Silva PA. A 6-year follow-up of childhood enuresis: prevalence in adolescence and consequences for mental health. J Paediatr Child Health. 1990; 26: 75-79.
22.
22. Fernandes ET, Reinburg Y, Vernier R, Gonzalez R. Neurogenic bladder dysfunction in children: review of pathophysiology and current management. J Pediatr.1994; 124: 1-7.
23.
23. Soler D, Borzyskowski M. Lower urinary tract dysfunction in children with central nervous system tumours. Arch Dis Child. 1998; 79: 344-347.
24.
24. Weider DJ, Sateia MJ, West RP. Nocturnal enuresis in children with upper airway obstruction. Otolaryngol Head Neck Surg. 1991; 105: 427-432.
25.
25. Steers WD, Suratt PM. Sleep apnoea as a cause of daytime and nocturnal enuresis. Lancet. 1997;349:1604-1604.
26.
26. Berul CI, Murphy JD. Nocturnal enuresis secondary to heart block: report of cure by cardiac pacemaker implantation. Pediatrics. 1993;92:284-285.
27.
27. Kozeny G, Wood W. Secondary enuresis associated with hyperthyroidism. J Fam Pract. 1986; 23: 273-274.
28.
28. Carroll JL, Loughlin GM. Diagnostic criteria for obstructive sleep apnea syndrome in children. Pediatr Pulmonol. 1992; 14: 71-74.
29.
29. Kriss VH, Kriss TC, Desai NS, Warf BC. Occult spinal dysraphism in the infant: clinical and sonographic review. Clin Pediatr. 1995; 34: 650-654.
30.
30. Robson WLM. Enuresis treatment in the United States. Scand J Urol Nephrol. 1999; 33: 56-60.
31.
31. Arikan N, Soygur T, Selcuki M, et al. Role of magnetic resonance imaging in children with voiding dysfunction: retrospective analysis of 81 patients. Urology. 1999; 54: 157-161.
32.
32. Ferber R. Solve Your Child's Sleep Problems. New York: Simon & Schuster; 1985.
33.
33. Forsythe WI, Butler RJ. Fifty years of enuretic alarms. Arch Dis Child. 1989; 64: 879-885.
34.
34. Robson WLM, Leung AKC. Intranasal desmopressin (DDAVP) in the treatment of nocturnal enuresis. A review of efficacy studies. Today's Therapeutic Trends. 1993; 2: 35-42.
35.
35. Hjilmas K, Hanson E, Hellstrom AL, et al. Long-term treatment with desmopressin in children with primary nmonosymptomaticnocturnal enuresis: an open multicentre study. BrJ Urol. 1998; 82: 704-709.
36.
36. Fjellestad-Paulsen A, Wille S, Harris AS. Comparison of intranasal and oral desmopressin for nocturnal enuresis. Arch Dis Child. 1987; 62: 674-677.
37.
37. Robson WLM, Leung AKC. Side effects and complications of treatment with desmopressin for enuresis.J Natl Med Assoc. 1994;86:775-778.
38.
38. Skoog SJ, Stokes A, Turner KL. Oral desmopressin: a randomized, doubleblind, placebo-controlled study of effectiveness in children with primary nocturnal enuresis. J Urol. 1997;158: 1035-1040.
39.
39. Robson WLM, Norgaard JP, Leung AKC. Hyponatremia in patients with nocturnal enuresis treated with DDAVP. Eur J Pediatr. 1996; 155:959-962.
40.
40. Cendron M, Klauber G. Combination therapy in the treatment of persistent nocturnal enuresis. Br J Urol. 1998; 81:26-28.
41.
41. Bradbury M. Combination therapy for nocturnal enuresis with desmopressin and an alarm device. Scand J Urol Nephrol. 1997; 31: 61-63.
42.
42. Rushton HG. Older pharmacologic therapy for nocturnal enuresis. Clin Pediatr. 1993; special issue: 10-13.
43.
43. Jonat S, Santer R, Schneppenheim R, et al. Effect of DDAVP on nocturnal enuresis in a patient with nephrogenic diabetes insipidus. Arch Dis Child. 1999; 81: 57-59.
44.
44. Malone PS, Wheeler RA, Williams JE. Continence in patients with spina bifida: long-term results. Arch Dis Child. 1994; 70: 107-110.
