Urologie pro praxi 3/2021

Diagnosing and treating with nocturnal enuresis

The enuresis in children, but also in the adolescent population, is a significant psychosocial problem. The enuresis with frequency about 15–20 % of five-year-old, 2–6 % of seven-year-old children, and persistence 1–2 % at adolescence is one of the most common diseases in children. According to the ICCS (International Children's Society of Continence), polysymptomatic enuresis (NMNE) is classified as incontinence with lower urinary tract dysfunction, monosymptomatic enuresis nocturna (MNE) is then defined as a separate unit. The controlled bladder filling and emptying is a dynamically evolving functional process that directly depends on an individual's age. With age, a reflexive bladder emptying is gradually changing to a controlled with mediated cortical pathway (it is usually completed at 4 years of age). The exact diagnostic procedures (medical history, drinking / voiding card, urination calendar, physical examination, ultrasonography, urodynamic examination, etc.) distinguish MNE from NMNE. The MNE treatment should not be started until after the age of 5 (drinking / voiding regimens, pharmacotherapy, alarms or alternative treatment). Treatment with NMNE should be preceded by removing the primary cause of urination (eg neurogenic disorders, subvesical obstruction, urinary tract infections, constipation, etc.). There is high percentage of recurrences necessary to assume after the end of the primarily successful treatment.

Keywords: enuresis nocturna, childhood, diagnostics, therapy.