[The system of management nocturnal enuresis based on functional classification]. / System leczenia moczenia nocnego oparty na podziale czynnosciowym.

ABSTRACT

UNLABELLED The aim of the study was to describe our diagnostic and therapeutic logarithm based on functional classification in children with enuresis, and effects of therapy based on this classification. MATERIALS AND METHODS: we reviewed charts of 123 children managed because of nocturnal enuresis (68 boys, 55 girls, aged 4-18 (mean 7,6) years). Every child had routinely performed ultrasonography, urinalysis, uroflowmetry with estimation of residual urine. Children with urinary tract infections or malformations of the urinary tract were not included in this study. At the first visit all children were instructed to conduct voiding diary. On the base of data from voiding diarys and uroflowmetries children are divided in two groups Group I (n=21) with monosymptomatic nocturnal enuresis. Group II (n=102) children with bladder dysfunction and enuresis. In the first group rehabilitation program with bladder training, conducting voiding diary and conditioning therapy with alarm device was introduced. In children with bladder dysfunctions therapy started with bladder training and pharmacotherapy of bladder dysfunction. RESULTS: 9 children (6 from Group I and 3 from Group II) started to wake after starting bladder training. 81 children from Group II improved bladder function. 30 children from Group II started to wake up during therapy of bladder dysfunction. In 44 children, who improved bladder function and still had episodes of nocturnal enuresis, therapy with alarm device was introduced. From all 66 children treated with alarm device 5 started to wake up without any one episode of wetting. In 20 children the ability to wake up before alarm started to ring occurred in the first month of therapy. 40 children need to be treated for the second month, in 5 children therapy was prolonged for the third month. 9 children did not learn to wake up for urination. We have 8 drop-outs. In 7 therapy was repeated because of recurrence. CONCLUSION: The system of treatment of nocturnal enuresis is effective both in children with monosymptomatic nocturnal enuresis and in children with enuresis and voiding dysfunction.