Paruszkiewicz Grzegorz
Medyczne Centrum Diagnostyki Urodynamicznej URODYN, Warszawa.
Wiad Lek. 2013;66(1):35-44.
The aim of this article is to review International Children's Continence Society guidelines on the recommended diagnostic evaluation and therapy for children with nocturnal enuresis. Nocturnal enuresis (NE) is the condition describing the symptom of wetting during sleep above the age of 5 years. NE is one of the most common disorders among children. Enuresis is characterised as monosymptomatic nocturnal enuresis (MNE) if there are no additional voiding problems. Children with other daytime symptoms (daytime incontinence, urgency, frequency) and nocturnal enuresis are said to have non-monosymptomatic nocturnal enuresis (NMNE). A careful medical history, including bladder diary, physical examination, urinalysis, an ultrasound of the urinary tract system will usually provide sufficient information for the physician to arrive at a diagnosis. Urodynamic, radiologic and endoscopic evaluation are not necessary in children with monosymptomatic nocturnal enuresis. Two first line treatment options of MNE are currently recommended: nonpharmacologic treatment and pharmacologic treatment (desmopressin). Nonpharmacologic treatment of enuresis includes motivational therapy, bladder-training exercises, fluid and food intake and enuresis alarm. Before using alarm treatment or desmopressin, simple therapeutic interventions should be considered. Children with nocturnal poliuria and normal bladder capacity will be more sensitive to desmopressin.
本文旨在回顾国际儿童尿控协会关于夜遗尿症患儿推荐诊断评估及治疗的指南。夜遗尿症（NE）是指5岁以上儿童睡眠期间尿床的症状。NE是儿童中最常见的病症之一。如果没有其他排尿问题，遗尿症被定义为单症状性夜遗尿症（MNE）。伴有其他日间症状（日间尿失禁、尿急、尿频）和夜遗尿症的儿童被称为非单症状性夜遗尿症（NMNE）。详细的病史，包括膀胱日记、体格检查、尿液分析、泌尿系统超声检查，通常会为医生做出诊断提供足够的信息。对于单症状性夜遗尿症患儿，不需要进行尿动力学、放射学和内镜检查评估。目前推荐MNE的两种一线治疗方案：非药物治疗和药物治疗（去氨加压素）。遗尿症的非药物治疗包括激励疗法、膀胱训练练习、液体和食物摄入以及遗尿警报。在使用警报治疗或去氨加压素之前，应考虑简单的治疗干预措施。夜间多尿且膀胱容量正常的儿童对去氨加压素更敏感。
