How is nocturnal enuresis treated in urinary incontinence?

Updated: Jan 22, 2021
  • Author: Sandip P Vasavada, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

While nocturnal enuresis—defined as involuntary loss of urine during sleep that occurs at least twice a week in children older than 5 years of age  for at least 3 months—is the most common urologic complaint in pediatric patients, it also affects a significant number of adults. Nocturnal enuresis in adults may have multiple underlying pathologies, and treatment should first target identifiable etiologies, although a generalized approach can then be followed, utilizing behavioral and lifestyle modifications followed by medical therapy. [93, 94]

Such basic measures as evening fluid restriction and daytime bladder training can be beneficial. [95]  Desmopressin (DDAVP) decreases nighttime urine production; it is administered orally for primary nocturnal enuresis and intranasally or sublingually for nocturnal polyuria. Imipramine (2 mg/kg/d) has been one of the most common pharmacologic therapies. Oxybutynin and other anticholinergics have been used.

Although pharmacologic treatment can help, the underlying disorder often returns after discontinuation. Conditioning therapy with moisture-sensitive alarms are effective. Positive results usually persist even after the device is removed.


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