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Infrequent enuresis, the uninvestigated majority: comparisons between children with enuresis of varying severity.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Pediatrisk inflammationsforskning/Nevéus)ORCID iD: 0000-0002-2760-2015
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Barnhälsovård och föräldraskap/Sarkadi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Barnonkologisk forskning/Ljungman)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.ORCID iD: 0000-0002-4590-4957
2015 (English)In: Journal of Pediatric Urology, ISSN 1477-5131, E-ISSN 1873-4898, Vol. 11, no 1, 24.e1-24.e6 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The main objective was to compare children with frequent enuresis (FE) and children with infrequent enuresis (IE) using anamnestic data and variables related to bladder and kidney function. A secondary aim was to look at the group of children who wet their beds every single night, a phenomenon we chose to call constant enuresis (CE).

SUBJECTS AND METHODS: The parents recorded the number of wet and dry nights for a period of 14 days, and measured the voided volumes as well as nocturnal urine production for 48 h. History data relevant to bladder and bowel function was also recorded.

RESULTS: The children could be grouped as follows: IE, n = 14; FE, n = 18; and CE, n = 22. The children with IE were slightly older than the other groups, IE mean 7.57; FE mean 6.22; CE, mean 6.56 (p = 0.004). When comparing the groups in terms of the measured parameters, only one significant difference was found: the FE group had larger average daytime voided volumes, but only when the first morning void was included. The only significantly differing anamnestic variable was previous daytime incontinence, which was more common among the children in the IE group.

CONCLUSIONS: When comparing children with varying enuresis severity, no major differences regarding bladder function and urine production were found. Furthermore, children with infrequent enuresis tend to be slightly older when they seek medical help.

Place, publisher, year, edition, pages
2015. Vol. 11, no 1, 24.e1-24.e6 p.
National Category
Pediatrics Urology and Nephrology
Identifiers
URN: urn:nbn:se:uu:diva-237744DOI: 10.1016/j.jpurol.2014.06.026ISI: 000351948300010PubMedID: 25270869OAI: oai:DiVA.org:uu-237744DiVA: diva2:768727
Available from: 2014-12-04 Created: 2014-12-04 Last updated: 2017-12-05
In thesis
1. The Family and the Wet Bed: The parents’ perspective and the child’s treatment
Open this publication in new window or tab >>The Family and the Wet Bed: The parents’ perspective and the child’s treatment
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The focus of this thesis is nocturnal enuresis in the primary care setting. Three aspects have been central: 1) the parental perspective, 2) differences between children with enuresis of varying severity, and 3) to explore whether the universally recommended basic bladder advice have any therapeutic effect.

 

Study I built on qualitative data from interviews with 13 parents of children with enuresis, focusing on family impact and coping strategies. A common consensus among the participants was that they felt frustrated about the perceived lack of information and help they received from the healthcare system. In study II anamnestic data and voiding chart parameters – reflecting renal and bladder function – were compared between 54 children with enuresis of varying frequency. No measurable differences were found. Study III was a randomised controlled study. Forty children with previously untreated enuresis were recruited and randomised to receive either first bladder advice for one month and then alarm therapy (n=20) or just the alarm therapy (n=20). The bladder advice did neither result in a significant reduction in the number of wet nights, nor improve the effect of subsequent alarm therapy.  Study IV was a cross-sectional questionnaire study of 52 parents, including comparison with normative data and with validated instruments evaluating intra-parental stress and satisfaction. The results showed no significant differences between the parents studied and normative data.

  

Study I and IV were the first to look at the parents, as opposed to children with enuresis. The results can be used by healthcare professionals when counselling families about strategies to use and attitudes to avoid. Study II aimed at filling a glaring blank in the field of knowledge: we do not know how children with infrequent enuresis differ from those who wet their beds often or every single night. The fact that no differences in bladder or kidney function was found indicates that they may differ in the way they sleep. Study III will probably have the greatest impact on how we should treat children with enuresis. The recommendation that all of them be given bladder training as a first-line therapy can no longer be supported.

 

 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 55 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1093
Keyword
Nocturnal Enuresis, Parents, Children, Treatment, Nursing
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-248496 (URN)978-91-554-9223-6 (ISBN)
Public defence
2015-05-22, Universitetshuset Sal IX, Biskopsgatan 3, Uppsala, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2015-04-28 Created: 2015-03-30 Last updated: 2015-07-07

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Cederblad, MariaSarkadi, AnnaEngvall, GunnNevéus, Tryggve

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