Assessment of Nocturnal Enuresis and its Approach among Paediatric Population

• Published in: NeuroQuantology Vol. 20; no. 16; p. 2370
• Main Authors: Montaser, Yara M, Shedeed, Soad, Samaha, Ibrahim I, Bahgat, Shereen M, AbdAllah, Amany M
• Format: Journal Article
• Language: English
• Published: Bornova Izmir NeuroQuantology 01.01.2022
• Subjects: Autism; Bladder; Central nervous system; Children; Mental disorders; Sleep; Urinary incontinence
• ISSN: 1303-5150
• DOI: 10.48047/NQ.2022.20.16.NQ880238

Background: Diurnal enuresis defines wetting while awake and nocturnal enuresis refers to voiding during sleep after a developmental age when bladder control should be established. According to International Children’s Continence Society (ICCS), nocturnal enuresis (NE) is defined as intermittent incontinence during periods of sleep in children older than 5 years age in which the sphincters control is acquired. It is normal voiding that happens at an inappropriate and socially unacceptable time and place. The Diagnostic & Statistical Manual of Mental Disorders (DSM- IV) defines nocturnal enuresis as an involuntary voiding of urine during sleep, with a frequency of at least twice a week, in children older than 5 years in the absence of congenital or acquired defects of the central nervous system. The child has no control over this elimination, nor is he or she aware that it is happening. Specific neuropsychological disorders, such as attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD), have an increased prevalence of enuresis, increased therapy resistance, and are often characterized by a disrupted sleep. Decades ago, psychological problems were considered to be the primary cause of incontinence in general and nocturnal enuresis in specific. With a structured approach involving history and physical examination added to ultrasound imaging of kidneys and bladder, recording of urinary flow and measurement of postvоid residual, the diagnosis of monosymptomatic nocturnal enuresis can be made with confidence.