• Childhood Kidney Diseases
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• v.16 no.1
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• pp.1-8
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• 2012

Nocturnal polyuria is one of the main pathogenic mechanisms of enuresis. Disturbance of circadian rhythm of antidiuretic hormone (ADH or AVP), hypercalciuria, and/or solute diuresis are considered to cause nocturnal polyuria, which in turn causes enuresis in patients with relatively small bladder capacity and high threshold for awakening. Evaluation of these factors would guide the therapeutic approach for enuresis.

• The Journal of Pediatrics of Korean Medicine
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• v.25 no.3
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• pp.1-11
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• 2011

Objectives: The purpose of this study is to investigate various treatments in other countries for nocturnal enuresis. We analyze the treatments on enuresis (within acupuncture, moxibustion, psychotherapy and chiropractic) and herb for 12 years (from 2000 to 2011). Methods: Databases include PubMed and Web of Science. To narrow the search, the following key search terms were used: 'enuresis, acupuncture', 'enuresis, moxibustion', 'enuresis, psychotherapy', 'enuresis, chiropractic' and 'enuresis, herb'. The search was limited to the publication date from 2000 to 2011. Results: There are 31 studies on enuresis treatment by using acupuncture, 3 on moxibustion, 91 on psychotherapy, and 8 on chiropractic. Among them, 27 studies on acupuncture, 3 on moxibustion, 86 on psychotherapy and 5 on chiropractic reveal that patients with enuresis benefit from the each treatment. Conclusions: In the future, various researches on acupoint are necessary. Especially, studies on enuresis by using psychotherapy and chiropractic are needed. With those efforts, treatments on enuresis will become more pragmatic and beneficial.

• The Journal of Pediatrics of Korean Medicine
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• v.34 no.1
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• pp.1-25
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• 2020

Objectives The purpose of this study is to identify the research trends and to evaluate the effectiveness and safety of Korean medicine treatment by analyzing the recently published clinical studies of Korean medicine treatment on nocturnal enuresis in children. Methods The literatures were searched from OASIS, KISS, NDSL, RISS, Cochrane, CINAHL, Embase, Pubmed, and only clinical studies published from 2000 to October 2019 were included. The publication year, study type, type of enuresis, demographic information of participants, duration of illness, intervention type and details, follow-up period, outcome measurements and adverse events of selected literatures were analyzed. Results A total of 38 studies were selected. In the selected studies, acupuncture was the most frequently used treatment for nocturnal enuresis, followed by herbal medicine, electrical stimulation treatment, moxibustion, acupressure and plaster therapy. The most commonly used acupoints for acupuncture were SP6 and CV4, and the most used herbal medicine was Chukcheonwhan, while Alpiniae Fructus (益智仁) and Dioscoreae Rhizoma (山藥) were the most used herbal materials. Most of the studies showed that the total effective rate of Korean medicine treatment was high. All the adverse events occurred in the Korean medicine treatment group were caused by acupuncture or puncture. Conclusions This study analyzed clinical studies of Korean medicine treatment on nocturnal enuresis in children, identified the research trends and evaluated the effectiveness and safety of the Korean medicine treatment.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1140-1146
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• 2008

Nocturnal enuresis is a heterogeneous disorder with various underlying pathophysiological mechanisms and causes a mismatch between the nocturnal bladder capacity and the amount of urine produced during sleep at night. It is associated with a simultaneous failure of conscious arousal in response to the sensation of bladder fullness. Generally, a complete history and physical examination, with a specific focus on the genitourinary, gastrointestinal, and neurologic systems, is sufficient to evaluate a patient with enuresis. The therapeutic focus is directed toward a differential approach based on the underlying mechanism and toward combination therapies such as alarm devices and desmopressin as well as anticholinergic agents and desmopressin. Children with increased nocturnal urine production usually have a good response to desmopressin therapy. Patients with a small bladder generally show a poor response to desmopressin treatment, but they would benefit more from combination therapy with enuretic alarm, urotherapy, and antimuscarinic agents in addition to desmopressin. Different types of bladder dysfunction, which result in a small nocturnal bladder capacity, probably contribute significantly to the pathogenesis of nocturnal enuresis, particularly in those with treatment failure and refractory symptoms. Because different clinical subgroups may show different responses to treatment, it is necessary to distinguish these subgroups before a decision on the specific treatment protocol can be made.

• The Journal of Pediatrics of Korean Medicine
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• v.19 no.1
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• pp.83-102
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• 2005

Objectives : This study aimed to investigate acupuncture trend of childhood nocturnal enuresis in current Traditional Chinese Medical Journals. Methods : During the period from January 2000 to August 2004, we searched all Traditional Chinese Medical Journals in oriental medical library in dongguk university. We selected 28 literatures on acupuncture treatment for nocturnal enuresis in children Results : 28 studies are included and classified by diagnosis criteria and outcome criteria. And reclassified into two large groups, case report and comparison study. Totally 2324 cases, complete cures are 1701, significant improvements 2239, complete cure rate 73.2%, total improvement rate 97.3% 33 acupuncture points are used and main meridians are bladder, conception vessel and governor vessel. Conclusion : There remains a debate about diagnosis and outcome criteria. But Acupuncture is very effective and safe in the treatment of enuretic children.

• Childhood Kidney Diseases
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• v.25 no.1
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• pp.40-43
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• 2021

Enuresis is intermittent urinary incontinence during sleep at night in children aged 5 years or older. The main pathophysiology of enuresis involves nocturnal polyuria, abnormal sleep arousal, and low functional bladder capacity. In rare cases, enuresis is an early symptom of endocrine disorders such as diabetes or thyroid disorders. Herein, we report a case of a 12-year-old girl with enuresis as a rare initial presentation of Graves' disease. She complained of nocturnal enuresis from a month before visiting our clinic. She also complained of urinary frequency, headache, and weight loss. On physical examination, she had tachycardia, intention tremors, and a diffuse goiter on her anterior neck with bruit on auscultation. Her thyroid function test results revealed hyperthyroidism, and Graves' disease was diagnosed as the thyroid stimulating hormone receptor autoantibody was positive. After treatment for Graves' disease with methimazole, symptoms of enuresis resolved within 2 weeks as she became clinically and biochemically euthyroid. In children with secondary enuresis, Graves' disease should be considered as a differential diagnosis, and signs of hyperthyroidism should be checked for carefully.

• Sleep Medicine and Psychophysiology
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• v.2 no.1
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• pp.23-30
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• 1995

Bedwetting is the most common urologic complaint among children. Wetting frequency decreases from birth to adolescence. Etiology is multifactorial : genetic, neuromuscular or urologic maturation, psychosocial stressors, toilet training, or biologic aspects. Treatment has been also multimodal : drugs to depress bladder activity, increase urethral resistance, or modulate sleep. and recently urine reduction modulation. All of these approaches reflect a lack of sufficient knowledge of the underlying pathophysiology of nocturnal enuresis. Recent researches have focused on sleep disturbances, bladder reservoir function, urine output, and a combination of the three. Sleep studies indicate that enuretic patients are normal sleepers, and enuresis can take place during any stage of sleep, but generally occurs when the bladder is filled to the equivalent of maximal daytime functional capacity. Bladder reservior capacity appears to be normal, and bladder instability is somewhat related with the pathology of nocturnal enuresis. However, enuretic patients have shown the lack of normal nocturnal increase in antidiuretic hormone levels, and nocturnal urine production increases up to 2-4 times volume of functional bladder capacity, which explains the need for bladder emptying. But behavioral approaches, especially Bell-alarm method, remain important in the treatment of primary enuresis.

• The Journal of Pediatrics of Korean Medicine
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• v.24 no.2
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• pp.159-168
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• 2010

Objectives This study to investigate the effect of oriental medical treatment including moxa bucket moxibustion on children with nocturnal enuresis. Methods We treated five cases of enuretic children with oriental medical treatment like moxa bucket moxibustion on Gwanwon(CV4) at every cases and acupuncture, TDP, herbal medicine at some cases. To investigate relapse, we followed up by telephone at least about 3 months after the end of the therapy. Results After the treatment, the number of enuresis before and after the treatment were compared. The number was decreased by 67% or more all cases. Conclusions According to the result, oriental medical treatment including moxa bucket moxibustion is considered to be effective on the nocturnal enuresis and further study is needed with more cases.

• The Journal of Pediatrics of Korean Medicine
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• v.32 no.2
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• pp.43-63
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• 2018

Objectives The purpose of this study is to evaluate the efficacy and safety of herbal medication for the treatment of nocturnal enuresis in children by analyzing randomized controlled trials conducted in China. Methods We searched literatures from China National Knowledge Infrastructure published up to 19 January, 2018. Selected literatures were collected and analyzed in order of publication year, and then demographic information, treatment method, duration of illness, duration of treatment, follow-up period, outcome measurement and adverse events. Results A total of 34 studies were selected for the analysis. In most studies, the total efficacy of the treatment group was reported to be higher than that of the control group, and the recurrence rate and complete cure rate were also found to be more effective in the herbal medicine treatment group. The most frequently used medical herb was Alpiniae Fructus (益智仁), and the use of medical herbs belong to tonifying yang (補陽藥), tonifying qi (補氣藥), and astringing essence strengthening collapse medicine (澁精縮尿止帶藥) were relatively high. The adverse events rate for the herbal medicine treatment group were significantly lower than those in the Western medicine treatment group. Conclusions This study showed that a herbal medicine treatment can be effective and safe option for treating pediatric nocturnal enuresis. However, additional well-designed clinical studies need to be performed to establish a basis.

• Childhood Kidney Diseases
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• v.14 no.2
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• pp.210-217
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• 2010

Purpose : Diabetes mellitus (DM) is known as one of the common causes of secondary enuresis in children. However, enuresis in diabetic children is overlooked only as a symptom of polyuria due to hyperglycemia. We evaluated the prevalence of nocturnal enuresis in children with diabetes mellitus in this paper. Methods : Among children with diabetes in three hospitals in Daegu area, 117 agreed to 'Tele research by means of a questionnaire'. Results : Diabetic patients were divided into two groups: Nocturnal enuresis and nonnocturnal enuresis group. thirty-two of 117 (27.0%) patients were in enuresis group, with more daytime urination than non-nocturnal enuresis group ($4.2{\pm}1.6/3.6{\pm}1.2$ times, P=0.016). HbA1c at diagnosis was $12.0{\pm}2.3%/12.0{\pm}2.5%$, and at follow-up $9.3{\pm}2.3%/8.3{\pm}2.3%$ (P =0.042). Insulin was administered at $1.1{\pm}0.5/1.1{\pm}0.4$ units/kg/day. Ten children of enuresis (31.2%) group were monosymptomatic (MNE) and 22 (68.8%) children were non-monosymptomatic enuresis (non-MNE). Fourteen (43.8%) of enuresis group had persistent symptoms, with 5 MNE and 9 non-MNE each. HbA1c at diagnosis was $11.1{\pm}2.5$, $12.4{\pm}2.1$, higher in non-MNE (P=0.144). Average arousal during sleep was step $3.3{\pm}1.2$, $2.5{\pm}1.0$, higher in improved enuresis group (P=0.059). Conclusion : Nocturnal enuresis among DM patients is underestimated. However, considering psychological and social effects of enuresis in children, extensive and long-term studies are needed in the future to clarify relationship between prevalence and DM control.