Pediatria pre prax 6/2005

CURRENT VIEW OF PATHOPHYSIOLOGY AND DIAGNOSIS OF MONOSYMPTOMATIC NOCTURNAL ENURESIS – PRINCIPLE OF THREE SYSTEMS

In our work we aimed to give actual information about the pathogenesis of monosymptomatic nocturnal enuresis (MNE) according to the principle of “three systems”. Upon recent research opinion enuresis is caused by mismatch between nocturnal urinary production and bladder capacity together with inability to awake, when this occurs. Therefore the diagnostic procedures in MNE have to be lead towards identification of the primary cause of nocturnal enuresis. The finding, which of the “three systems” (nocturnal urinary production, bladder capacity and sleep) is the most responsible for MNE in a concrete patient, will help to select the appropriate individualized therapy (desmopressin, anticholinegic treatment, alarm treatment).

Keywords: enuresis, pathophysiology, polyuria, bladder, sleep, diagnosis.