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PubMedDate not supplied

Relationship between parental attitude towards the emotionally disturbed child and nocturnal enuresis.

In a study of children with nocturnal enuresis a close relationship was found between disturbed family environment and the frequency of enuresis. It will appear that negative parental attitudes in contrast to positive ones, as defined in this paper, are predisposing factors for the appearance of nocturnal enuresis. It is well known that nocturnal enuresis is one of the most serious problems encountered in children. It is estimated that over 25 percent of the children examined in Child Guidance Clinics suffer from nocturnal enuresis. In fact enuresis is considered the most common reason for referral of children to such Clinics. Much has been said about the etiology of nocturnal enuresis, and the organic factor was considered to be of primary importance by physicians of past generations. Spina bifida, local infections, small cyst, adenoids, epilepsy and mental retardation were at times considered as the main causes. Today the organic factor is accepted as an important one in a percentage not exceeding that of five percent. As a psychological psychosomatic phenomenon, nocturnal enuresis is considered to be the result of many interacting factors. One of the psychological factors is known to be the child-parent relationship and the influence of the family environment as a whole. The purpose of this paper is the study of the influence of the family environment on the frequency of nocturnal enuresis regardless of the parents' reactions to the enuresis itself.

Adolescent↗

PubMed2026

Neurocorrelates of nocturnal enuresis in pre-adolescent children.

INTRODUCTION: Nocturnal enuresis (NE) is a common neurodevelopmental condition, yet its underlying neural mechanisms remain unclear. This study leverages the large-scale Adolescent Brain Cognitive Development (ABCD) dataset to identify structural and functional brain correlates associated with active symptoms and the resolution of bedwetting. METHODS: Using cross-sectional data from 3472 participants aged 9-10 years, children were categorized into three groups: active nocturnal enuresis (ANE, n = 225), history of nocturnal enuresis (HNE, n = 1171), and healthy control groups (CG, n = 2076). Multimodal neuroimaging protocol evaluated macrostructural properties via structural MRI (sMRI), microstructural white matter integrity via diffusion MRI (dMRI), and functional connectivity via resting-state fMRI (fMRI). Group differences were evaluated using linear models within an ANCOVA framework, adjusting for intracranial volume and handedness with False Discovery Rate (FDR) correction. RESULTS: Compared to controls, the ANE group exhibited a significant volume deficit in the right caudate, decreased sulcal depth in the left insula, and lower internal correlation within the Cingulo-Opercular Network (CON). Conversely, the dry HNE group demonstrated significant structural adaptations, including bilaterally larger putamen volumes and increased right caudate volume compared to the ANE group. The HNE group also showed increased microstructural density (decreased mean diffusivity) in the bilateral hippocampus and an increased cortical surface area in the left insula. Both NE groups demonstrated persistently reduced functional coupling within the CON. CONCLUSIONS: Nocturnal enuresis appears to be associated with a potential complex central signaling deficits. Reduced internal correlation within the CON across both active and former bedwetters indicates a potential for impairment in processing internal homeostatic bladder signals during sleep.

Humans↗

PubMed1978

DDAVP in childhood nocturnal enuresis.

A double-blind study of 18 children aged 6--12 years suffering from primary nocturnal enuresis without signs of underlying organic disease is reported. 20 microgram of DDAVP (desamino-D-arginine vasopressin, Minirin) was given intranasally at bedtime. The effect was prompt and satisfactory in 8 children and relatively good in another 8 children. No adverse effects were noted. DDAVP is advocated for temporary use in children with nocturnal enuresis needing immediate help.

Arginine Vasopressin↗

PubMed2026

Sociodemographic and clinical characteristics associated with nocturnal enuresis among children in a tertiary care center in Cairo, Egypt: A cross-sectional study.

BACKGROUND: Nocturnal enuresis (NE) is a significant pediatric health concern that warrants increased attention from healthcare providers, educators, and society. This study aimed to determine the frequency of NE among children attending a tertiary care center in Cairo, Egypt, and to explore their sociodemographic characteristics and associated factors. METHODS: A cross-sectional study was conducted among 1587 children aged 6-16 years attending a tertiary care center in Cairo from December 2022 to February 2024. Data were obtained from parents via a structured questionnaire covering sociodemographic characteristics. Sleep problems were assessed via the Children's Sleep Habits Questionnaire. The multivariate logistic regression analysis was conducted to estimate the odds ratio and identify factors associated with NE. RESULTS: The total prevalence of NE among children attending a tertiary care center was 333 (21%). Our results indicated that being female and being older were associated with a lower likelihood of NE. Low socioeconomic status (OR = 5.559; 95% CI = 1.24-24.88), stressful events (OR = 3.697; 95% CI = 1.73-7.88), a family history of NE (OR = 26.231; 95% CI = 8.617-79.85), and sleep problems (OR = 13.233; 95% CI = 6.082-28.793) were associated with increased odds of NE. Furthermore, consuming caffeinated drinks before sleep, the presence of urinary tract infections, and intestinal infestations were also associated with NE. CONCLUSION: The findings of the present study confirm the multifactorial etiology of NE and identify several associated factors. Integrating these factors into screening and management programs may improve early identification and lead to more effective, tertiary care-specific preventive and therapeutic interventions.

Humans↗

PubMed2026

Ginkgo biloba versus desmopressin in treatment of children with monosymptomatic nocturnal enuresis: A randomized controlled trial.

OBJECTIVE: To evaluate the efficacy and safety of Ginkgo biloba extract (GBE) compared with Desmopressin and their combination in children with monosymptomatic nocturnal enuresis (MNE). METHODS: In this double-blind, randomized, placebo-controlled trial, 398 children aged 5-14 years with MNE were assigned to four groups: placebo, GBE (60 mg daily), Desmopressin (0.2 mg daily), or GBE plus Desmopressin for 3 months. Primary outcomes included the number of wet nights per week. Secondary outcomes assessed sleep quality using the Sleep Disturbance Scale for Children (SDSC), arousal by the Disorders of Arousal (DA) score, and quality-of-life using the Pediatric Incontinence Questionnaire (PinQ). RESULTS: After 3 months, the combination group demonstrated the greatest improvement in wet nights (median 0 [IQR 0-2]) compared to GBE (6 [0.5-6.5]) and Desmopressin (2 [0-6]) (p < 0.001). Full response rates (≥90% reduction in wet nights) were highest with combination therapy (88.3%), followed by Desmopressin (46.5%), GBE (24.8%), and placebo (9.5%) (p < 0.001). GBE-containing groups showed significantly increased DA and SDSC scores, indicating enhanced arousal and lighter sleep. Quality-of-life (PinQ) score decreased in all treatment groups denoting improvement, with the best outcomes observed in the combination arm. Adverse effects were mild and comparable across groups, and serum sodium levels remained stable. CONCLUSION: GBE is a safe and effective novel therapy for MNE, improving sleep arousal and symptom control. Its combination with Desmopressin offers superior efficacy, better quality of life, and lower relapse rates than either agent alone.

Humans↗

PubMed1976

Nocturnal enuresis in childhood.

Of some 12,000 children in the National Child Development Study for whom the information was available, 10-7 per cent were enuretic between the ages of five and seven years, and 4-8 per cent were enuretic at 11 years. More boys than girls were wet at 11 years, although there was no difference at seven years. At both ages the manual social-classes were over-represented among the children with enuresis. These findings add support to the theory that nocturnal enuresis has multiple causes. The relative importance of social, developmental and psychiatric factors varies with the different groups of children early bed-wetting being associated with delayed development and later enuresis being more strongly associated with behaviour difficulties.

Age Factors↗

PubMed1978

Trial of an alpha-adrenolytic drug (indoramin) for nocturnal enuresis.

The investigation of methods of treatment known to be effective in controlling nocturnal enuresis may yield information on the pathophysiology of the condition. An attempt has been made to mimic the known alpha-adrenolytic action of imipramine by treating a group of 14 enuretic school-children with a competitive alpha-adrenoceptor blocking substance, indoramin. Treatment in the doses used had no significant effect on night-wetting frequency.

Adrenergic alpha-Antagonists↗

PubMed1978

Desmopressin in the management of nocturnal enuresis in children: a double-blind study.

Desmopressin (1-desamino-[8-D-Arg]-vasopressin) (DDAVP) was given by nose drops to 22 children with persistent nocturnal enuresis (mean age, 6.6 +/- 2.9 years; range, 4 to 12 years) the evening before sleep. With saline alone as placebo and with comparison to enuretic frequency before the onset of the trial, fortnightly periods were compared under double-blind conditions with the children at home. Pretreatment and placebo fortnights showed wetting frequencies (nights per fortnight) of 10.6 +/- 4.9 and 11.0 +/- 4.4, respectively. The value of the fortnight during desmopressin therapy was 4.2 +/- 4.5, which was significantly different from either of the previous means (P less than .01). Of the 22 subjects, four failed to react to therapy at all. There was decreased enuretic frequency in the remaining 18, of whom 12 decreased markedly or ceased wetting. One month after the trial, seven of the respondents were dry with desmopressin therapy. There was clear evidence of a large nocturnal volume of dilute urine before treatment in six of the respondents in whom such measurements could be reliably made. These children responded to dehydration with urine concentration, however, so that the suggestion can be made that a failure to develop a normal diurnal pattern of urine volume and concentration may underly some cases of enuresis.

Administration, Intranasal↗

PubMed1979

Nocturnal enuresis.

Primary enuresis is essentially of two main types - the common diurnal-nocturnal type with associated bladder instability and the less common nocturnal type which shows normal cystometry. The importance of depth of sleep in both types is stressed, particularly the former. A rationale of treatment, self-monitored, voluntary, escalating cystometry, is described.

Adolescent↗

PubMed1977