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Primer Enurezis Nocturna Tanılı Hastalarda En Zor Sorular:Doğru tedavi? Doğru süre?

Year 2020, Volume: 8 Issue: 3, 339 - 343, 20.12.2020
https://doi.org/10.37696/nkmj.677624

Abstract

Amaç
Çalışmamızda monosemptomatik enurezis nocturna tanısı ile daha önceden kısa dönem medikal tedavi almış ancak tekrar nüks olmuş hastalarda 6 aylık kombine desmopressin ve davranış tedavisinin etkinliğinin retrospektif olarak değerlendirilmesini amaçladık.
Materyal-metod
Çocuk nefroloji polikliniğine monosemptomatik enurezis nocturna tanısıyla basvuran hastaların dosyaları retrospektif olarak tarandı. 1 aylık ve 3 aylık desmopressin melt tedavisi başlanıp tam veya kısmi yanıt almış ancak tedavi bitiminde nüks olması nedeniyle çocuk hekimleri tarafından yönlendirilip 6 aylık desmopressin tedavisi ve davranış tedavisi verilip tedavi sürecini tamamlamış olan hastalar alındı.
Bulgular
Hastaların yaş ortalamaları 11±2,10(minimum 6, maksimum 17 yaş) olarak bulundu. Desmopressin ve davranış tedavisi 6 aya tamamlanan 148 hastanın 121 (%81,70)’sinde tam kuruluk sağlanırken, 12(%8,10) hastada kısmi yanıt izlendi. 15(%10,20) hasta ise yanıtsız olarak değerlendirildi. 26(%17,50) hastada tedavi bitiminden sonraki 3 ay içinde nüks görüldü. Nüks olan ve tedaviye cevapsız olan 16 hastanın <12 yaş olduğu görüldü.
Sonuç
Enurezis nocturnada tedavinin başarı ile tamamlanması ve nüks riskini azaltmak için medikal tedaviye mutlaka davranış tedavisinin de eklenmesi oldukça önemlidir. Altta yatan nöroürolojik immatürite tedavinin başarı şansını anlamlı derecede etkilemektedir.

Supporting Institution

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Project Number

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Thanks

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References

  • Kaynaklar 1. Kamperis K, Van Herzeele C, Rittig S, Vande Walle. Optimizing response to desmopressin in patients with monosymptomatic nocturnal enuresis. J. Pediatr Nephrol. 2017 Feb;32(2):217-226. doi: 10.1007/s00467-016-3376-7. 2. Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children's Continence Society. J Urol. 2014 Jun;191(6):1863-1865.e13. doi: 10.1016/j.juro.2014.01.110. 3. Ravanshad Y, Azarfar A, Esmaeeli M, Mostafavian Z, Zahabi E, Ravanshad S. Effect of Low Dose Imipramine in Patients with Nocturnal Enuresis, A Randomized Clinical Trial. Iran J Kidney Dis. 2019 Jul;13(4):257-261. 4. Oğra, E Ağlamış, MÖ Yücel. Monosemptomatik enürezis nokturnalı hastalarda tedavi ve takip sonuçlarımız. Dicle Medical Journal. 2013; 40 (3): 410-413 doi: 10.5798/diclemedj.0921.2013.03.0299 5. Eray Ş, Tekcan D, Baran Y. More anxious or more shy? Examining the social anxiety levels of adolescents with primary enuresis nocturna: a controlled study. J ped uro 2019 ; 15 (4): 343.e1-343.e5. doi: 10.1016/j.jpurol.2019.04.002 6. B Katı, EC Polat, HA Kurt, K Gümüş. Şanlıurfa İlindeki Primer Enürezis Nokturna Şikâyeti ile Gelen Hastaların Değerlendirilmesi. Türkiye Çocuk Hastalıkları. ,dergipark.org.tr 2017;11 (4): 239 - 242
  • 7. Theunis M,Van Hoecke E,Paesbrugge S, Hoebeke P, Vande Walle J. Self-image and performance in children with nocturnal enuresis. Eur Urol 2002;41(6):660-7 8. Kılıçoğlu AG, Mutlu C, Bahali MK, Adaletli H, Güneş H, Duman HM. Impact of enuresis nocturna on health-related quality of life in children and their mothers. Journal of Pediatric Urology. 2014;10(6):1261-6 9. Van Herzeele C, Dhondt K, Roels SP, Raes A, Hoebeke P, Groen LA, Vande Walle J. Desmopressin (melt) therapy in children with monosymptomatic nocturnal enuresis and nocturnal polyuria results in improved neuropsychological functioning and sleep. Pediatr Nephrol. 2016 Sep;31(9):1477-84. doi: 10.1007/s00467-016-3351-3 10. Del Gado R, Del Gaizo D, Cennamo M, Auriemma R, Del Gado G, Vernì M. Desmopressin is a safe drug for the treatment of enuresis. Scand J Urol Nephrol. 2005;39(4):308-12. 11. Ferrara P, Romano V, Cortina I, Ianniello F, Fabrizio GC, Chiaretti A. Oral desmopressin lyophilisate (MELT) for monosymptomatic enuresis: structured versus abrupt withdrawal. J Pediatr Urol. 2014 Feb;10(1):52-5. doi: 10.1016/j.jpurol.2013.05.021 12. Sharifiaghdas F, Sharifiaghdas S, Taheri M. Primary Monosymptomatic Nocturnal Enuresis: Monotherapy vs Combination Therapy. Urology. 2016 Jul;93:170-4. doi: 10.1016/j.urology.2016.02.013. 13 Ozden C, Ozdal OL, Aktas BK, Ozelci A, Altinova S, Memis A. The efficacy of the addition of short-term desmopressin to alarm therapy in the treatment of primary nocturnal enuresis. . Int Urol Nephrol. 2008;40(3):583-6. doi: 10.1007/s11255-008-9355-6. 14. Berkenwald A, Pires J, Ellsworth P. Evaluating use of higher dose oxybutynin in combination with desmopressin for refractory nocturnal enuresis. J Pediatr Urol. 2016 Aug;12(4):220.e1-6. doi: 10.1016/j.jpurol.2016.05.029. 15. Ferrara P, Del Vescovo E, Ianniello F, Franceschini G, Romaniello L, Verrotti A. Desmopressin 120 mcg, 180 mcg, 240 mcg: The right treatment for the right patient. Arch Ital Urol Androl. 2018 Jun 30;90(2):127-129. doi: 10.4081/aiua.2018.2.127. 16. Jabbour M, Abou Zahr R, Boustany M. Primary Nocturnal Enuresis: A Novel Therapeutic Strategy With Higher Efficacy. Urology. 2019 Feb;124:241-247. doi: 10.1016/j.urology.2018.09.013. 17. Ohtomo Y, Umino D, Takada M, Fujinaga S, Niijima S, Shimizu T. Gradual tapering of desmopressin leads to better outcome in nocturnal enuresis. Pediatr Int. 2015 Aug;57(4):656-8. doi: 10.1111/ped.12614. 18. Lottmann H, Baydala L, Eggert P, Klein BM, Evans J, Norgaard JP. Long-term desmopressin response in primary nocturnal enuresis: open-label, multinational study. Int J Clin Pract. 2009 Jan;63(1):35-45. doi: 10.1111/j.1742-1241.2008.01956.x. 19. Ma Y, Shen Y, Liu X. Association between enuresis and obesity in children with primary monosymptomatic nocturnal enuresis. Int Braz J Urol. 2019 Jul-Aug;45(4):790-797. doi: 10.1590/S1677-5538.IBJU.2018.0603. 20. Savaser S, Kizilkaya Beji N, Aslan E, Gozen D. The Prevalence of Diurnal Urinary Incontinence and Enuresis and Quality of Life: Sample of School. Urol J. 2018 Jul 10;15(4):173-179. doi: 10.22037/uj.v0i0.3982
  • 21. Schroeder MK, Juul KV, Mahler B, Nørgaard JP, Rittig S. Desmopressin use in pediatric nocturnal enuresis patients: is there a sex difference in prescription patterns? Eur J Pediatr. 2018 Mar;177(3):389-394. doi: 10.1007/s00431-017-3074-x.. 22. McKeigue PM, Reynard JM Relation of nocturnal polyuria of the elderly to essential hypertension. Lancet. 2000 Feb 5;355(9202):486-8. 23. Kruse A, Mahler B, Rittig S, Djurhuus JC. Increased nocturnal blood pressure in enuretic children with polyuria. J Urol. 2009 Oct;182(4 Suppl):1954-60. doi: 10.1016/j.juro.2009.04.079.
Year 2020, Volume: 8 Issue: 3, 339 - 343, 20.12.2020
https://doi.org/10.37696/nkmj.677624

Abstract

Project Number

yok

References

  • Kaynaklar 1. Kamperis K, Van Herzeele C, Rittig S, Vande Walle. Optimizing response to desmopressin in patients with monosymptomatic nocturnal enuresis. J. Pediatr Nephrol. 2017 Feb;32(2):217-226. doi: 10.1007/s00467-016-3376-7. 2. Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children's Continence Society. J Urol. 2014 Jun;191(6):1863-1865.e13. doi: 10.1016/j.juro.2014.01.110. 3. Ravanshad Y, Azarfar A, Esmaeeli M, Mostafavian Z, Zahabi E, Ravanshad S. Effect of Low Dose Imipramine in Patients with Nocturnal Enuresis, A Randomized Clinical Trial. Iran J Kidney Dis. 2019 Jul;13(4):257-261. 4. Oğra, E Ağlamış, MÖ Yücel. Monosemptomatik enürezis nokturnalı hastalarda tedavi ve takip sonuçlarımız. Dicle Medical Journal. 2013; 40 (3): 410-413 doi: 10.5798/diclemedj.0921.2013.03.0299 5. Eray Ş, Tekcan D, Baran Y. More anxious or more shy? Examining the social anxiety levels of adolescents with primary enuresis nocturna: a controlled study. J ped uro 2019 ; 15 (4): 343.e1-343.e5. doi: 10.1016/j.jpurol.2019.04.002 6. B Katı, EC Polat, HA Kurt, K Gümüş. Şanlıurfa İlindeki Primer Enürezis Nokturna Şikâyeti ile Gelen Hastaların Değerlendirilmesi. Türkiye Çocuk Hastalıkları. ,dergipark.org.tr 2017;11 (4): 239 - 242
  • 7. Theunis M,Van Hoecke E,Paesbrugge S, Hoebeke P, Vande Walle J. Self-image and performance in children with nocturnal enuresis. Eur Urol 2002;41(6):660-7 8. Kılıçoğlu AG, Mutlu C, Bahali MK, Adaletli H, Güneş H, Duman HM. Impact of enuresis nocturna on health-related quality of life in children and their mothers. Journal of Pediatric Urology. 2014;10(6):1261-6 9. Van Herzeele C, Dhondt K, Roels SP, Raes A, Hoebeke P, Groen LA, Vande Walle J. Desmopressin (melt) therapy in children with monosymptomatic nocturnal enuresis and nocturnal polyuria results in improved neuropsychological functioning and sleep. Pediatr Nephrol. 2016 Sep;31(9):1477-84. doi: 10.1007/s00467-016-3351-3 10. Del Gado R, Del Gaizo D, Cennamo M, Auriemma R, Del Gado G, Vernì M. Desmopressin is a safe drug for the treatment of enuresis. Scand J Urol Nephrol. 2005;39(4):308-12. 11. Ferrara P, Romano V, Cortina I, Ianniello F, Fabrizio GC, Chiaretti A. Oral desmopressin lyophilisate (MELT) for monosymptomatic enuresis: structured versus abrupt withdrawal. J Pediatr Urol. 2014 Feb;10(1):52-5. doi: 10.1016/j.jpurol.2013.05.021 12. Sharifiaghdas F, Sharifiaghdas S, Taheri M. Primary Monosymptomatic Nocturnal Enuresis: Monotherapy vs Combination Therapy. Urology. 2016 Jul;93:170-4. doi: 10.1016/j.urology.2016.02.013. 13 Ozden C, Ozdal OL, Aktas BK, Ozelci A, Altinova S, Memis A. The efficacy of the addition of short-term desmopressin to alarm therapy in the treatment of primary nocturnal enuresis. . Int Urol Nephrol. 2008;40(3):583-6. doi: 10.1007/s11255-008-9355-6. 14. Berkenwald A, Pires J, Ellsworth P. Evaluating use of higher dose oxybutynin in combination with desmopressin for refractory nocturnal enuresis. J Pediatr Urol. 2016 Aug;12(4):220.e1-6. doi: 10.1016/j.jpurol.2016.05.029. 15. Ferrara P, Del Vescovo E, Ianniello F, Franceschini G, Romaniello L, Verrotti A. Desmopressin 120 mcg, 180 mcg, 240 mcg: The right treatment for the right patient. Arch Ital Urol Androl. 2018 Jun 30;90(2):127-129. doi: 10.4081/aiua.2018.2.127. 16. Jabbour M, Abou Zahr R, Boustany M. Primary Nocturnal Enuresis: A Novel Therapeutic Strategy With Higher Efficacy. Urology. 2019 Feb;124:241-247. doi: 10.1016/j.urology.2018.09.013. 17. Ohtomo Y, Umino D, Takada M, Fujinaga S, Niijima S, Shimizu T. Gradual tapering of desmopressin leads to better outcome in nocturnal enuresis. Pediatr Int. 2015 Aug;57(4):656-8. doi: 10.1111/ped.12614. 18. Lottmann H, Baydala L, Eggert P, Klein BM, Evans J, Norgaard JP. Long-term desmopressin response in primary nocturnal enuresis: open-label, multinational study. Int J Clin Pract. 2009 Jan;63(1):35-45. doi: 10.1111/j.1742-1241.2008.01956.x. 19. Ma Y, Shen Y, Liu X. Association between enuresis and obesity in children with primary monosymptomatic nocturnal enuresis. Int Braz J Urol. 2019 Jul-Aug;45(4):790-797. doi: 10.1590/S1677-5538.IBJU.2018.0603. 20. Savaser S, Kizilkaya Beji N, Aslan E, Gozen D. The Prevalence of Diurnal Urinary Incontinence and Enuresis and Quality of Life: Sample of School. Urol J. 2018 Jul 10;15(4):173-179. doi: 10.22037/uj.v0i0.3982
  • 21. Schroeder MK, Juul KV, Mahler B, Nørgaard JP, Rittig S. Desmopressin use in pediatric nocturnal enuresis patients: is there a sex difference in prescription patterns? Eur J Pediatr. 2018 Mar;177(3):389-394. doi: 10.1007/s00431-017-3074-x.. 22. McKeigue PM, Reynard JM Relation of nocturnal polyuria of the elderly to essential hypertension. Lancet. 2000 Feb 5;355(9202):486-8. 23. Kruse A, Mahler B, Rittig S, Djurhuus JC. Increased nocturnal blood pressure in enuretic children with polyuria. J Urol. 2009 Oct;182(4 Suppl):1954-60. doi: 10.1016/j.juro.2009.04.079.
There are 3 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Orginal Article
Authors

Mehtap Çelakıl 0000-0002-5354-1455

Project Number yok
Publication Date December 20, 2020
Published in Issue Year 2020 Volume: 8 Issue: 3

Cite

APA Çelakıl, M. (2020). Primer Enurezis Nocturna Tanılı Hastalarda En Zor Sorular:Doğru tedavi? Doğru süre?. Namık Kemal Tıp Dergisi, 8(3), 339-343. https://doi.org/10.37696/nkmj.677624
AMA Çelakıl M. Primer Enurezis Nocturna Tanılı Hastalarda En Zor Sorular:Doğru tedavi? Doğru süre?. NKMJ. December 2020;8(3):339-343. doi:10.37696/nkmj.677624
Chicago Çelakıl, Mehtap. “Primer Enurezis Nocturna Tanılı Hastalarda En Zor Sorular:Doğru Tedavi? Doğru süre?”. Namık Kemal Tıp Dergisi 8, no. 3 (December 2020): 339-43. https://doi.org/10.37696/nkmj.677624.
EndNote Çelakıl M (December 1, 2020) Primer Enurezis Nocturna Tanılı Hastalarda En Zor Sorular:Doğru tedavi? Doğru süre?. Namık Kemal Tıp Dergisi 8 3 339–343.
IEEE M. Çelakıl, “Primer Enurezis Nocturna Tanılı Hastalarda En Zor Sorular:Doğru tedavi? Doğru süre?”, NKMJ, vol. 8, no. 3, pp. 339–343, 2020, doi: 10.37696/nkmj.677624.
ISNAD Çelakıl, Mehtap. “Primer Enurezis Nocturna Tanılı Hastalarda En Zor Sorular:Doğru Tedavi? Doğru süre?”. Namık Kemal Tıp Dergisi 8/3 (December 2020), 339-343. https://doi.org/10.37696/nkmj.677624.
JAMA Çelakıl M. Primer Enurezis Nocturna Tanılı Hastalarda En Zor Sorular:Doğru tedavi? Doğru süre?. NKMJ. 2020;8:339–343.
MLA Çelakıl, Mehtap. “Primer Enurezis Nocturna Tanılı Hastalarda En Zor Sorular:Doğru Tedavi? Doğru süre?”. Namık Kemal Tıp Dergisi, vol. 8, no. 3, 2020, pp. 339-43, doi:10.37696/nkmj.677624.
Vancouver Çelakıl M. Primer Enurezis Nocturna Tanılı Hastalarda En Zor Sorular:Doğru tedavi? Doğru süre?. NKMJ. 2020;8(3):339-43.