Pediatric Nephrology, University Children's Hospital Münster, Waldeyerstrasse 22, 48149, Muenster, Germany.
Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421, Homburg, Germany.
Pediatr Nephrol. 2018 Jul;33(7):1145-1154. doi: 10.1007/s00467-017-3778-1. Epub 2017 Aug 21.
Nocturnal enuresis (NE) is a common health problem. Approximately 10% of 7-year-old children wet the bed regularly during sleep. Enuresis can be categorized into monosymptomatic (MEN) and nonmonosymptomatic (NMEN) forms. MEN occurs without any other symptoms of bladder dysfunction. NMEN is associated with dysfunction of the lower urinary tract with or without daytime incontinence. The rate of comorbid gastrointestinal, behavioral, and emotional disorders is elevated depending upon the subtype of NE. A careful clinical history is fundamental to the evaluation of enuresis. Diagnostic procedures include medical history and psychological screening with questionnaires, bladder and bowel diary, physical examination, urinalysis, ultrasound, and examination of residual urine. The mainstay of treatment is urotherapy with information and psychoeducation about normal lower urinary tract function, the underlying cause of MEN, disturbed bladder dysfunction in the child with NMEN and instructions about therapeutic strategies. Alarm therapy and the use of desmopressin have been shown to be effective in randomized trials. Children with NMEN first need treatment of the underlying daytime functional bladder problem before treatment of nocturnal enuresis. In patients with findings of overactive bladder, besides urotherapy, anticholinergic drugs may be useful.
遗尿症（NE）是一种常见的健康问题。大约 10%的 7 岁儿童在睡眠中经常尿床。遗尿症可分为单症状性（MEN）和非单症状性（NMEN）。MEN 发生时没有任何膀胱功能障碍的其他症状。NMEN 与下尿路功能障碍有关，伴有或不伴有日间尿失禁。根据 NE 的亚型，合并胃肠道、行为和情绪障碍的发生率升高。仔细的临床病史是遗尿症评估的基础。诊断程序包括病史和问卷调查的心理筛查、膀胱和肠道日记、体格检查、尿液分析、超声检查和残余尿检查。治疗的主要方法是尿疗，包括关于正常下尿路功能、MEN 的潜在原因、NMEN 儿童膀胱功能障碍以及治疗策略的信息和心理教育。在随机试验中，警报疗法和去氨加压素的使用已被证明是有效的。NMEN 儿童首先需要治疗日间功能性膀胱问题，然后再治疗夜间遗尿症。对于逼尿过度的患者，除了尿疗外，抗胆碱能药物可能也有用。
