Therapy concept in enuretic children.

Abstract

More than 700 children aged between 5 and 15 years were treated at the University of Vienna Department of Urology during the last 10 years. The therapeutic approach was based on a complex diagnostic scheme to define the individual problem of each enuretic child. Generally speaking the enuresis problem turned out to be a symptom of delayed maturation of fine motor control [1] or sleep and hormone secretion rhythm during day and night hours. In a high percentage of enuretic children, no major physical problem or disease could be found, but the possibility of a physical problem, especially a neurourological problem, should not be ignored. Nonneurogenic discoordinated voiding in children can be treated by cognitive flow-triggered feedback training [2, 3] while overproduction of urine during sleep is reduced by antidiuretic hormone therapy with desmopressin (DDAVP; 1-deamino-8-D-arginine-vasopressin), a synthetic analogue of antidiuretic hormone.