• The Journal of Pediatrics of Korean Medicine
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• v.18 no.2
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• pp.77-91
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• 2004

Objectives : In evaluating a child with enuresis, an organized approach to the history leads to a working diagnosis and an appropriate treatment plan. but, there's no study about history taking in enuretic children. This article was undertaken to evaluate the enuretic child exactly and to study nocturnal enuresis systematically. Methods : It was conducted a computerized literature search in following database: Medline (via Pubmed), NDSL, EBSCO. Korean articles via oriental pediatric association homepage, KISS. Key words to search were 'nocturnal enuresis', 'bedwetting', 'enuresis', 'incontinence', 'management', 'evaluation', 'assessment', 'questionnaire', 'guideline', 'voiding dysfunction'. Results : Questions are grouped in eight categories: primary history(sex, age, height, weight), family history, enuresis history(primary/secondary, frequency, time of enuresis, nocturia), voiding history(average number, frequency, pattern, volume, posture, daytime enuresis), medical history, constipation/encopresis, sleep(OSA). Conclusion : A careful, complete history taking will help to plan treatment properly and to study.

• The Journal of Pediatrics of Korean Medicine
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• v.20 no.2
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• pp.139-146
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• 2006

Objective : The objective of this study is to assess the clinical effect of Gikwuibosin_tang on nocturnal enuretic children. Methods : This clinical study was carried out with 15 cases of children aged 5 to 10 years old who visited the 00 Oriental Clinic between February 2005 and August 2005 and who were diagnosed as the nocturnal enuresis. The data of present symptom and improvement progress was collected a telephone interviews with their mother. Results : The total number of children was 15, 10 of them were male and 5 were female. Sex ratio was 2:1. Patients under 6 years old were 9(60%). After the treatment of oriental medicine der $2{\sim}3$ months, 6 of the children were improved completely and 7 of them were cured quite well, 2 of them were recovered in a half way. the treatment performed very well so there's no case which were not improved at all. And a ratio of the perfect cure was 40%. Following-up survey by telephone, the treatment were performed completely for 8 of them and 4 of them were almost improved but 3 of them were not improved. And a ratio of the perfect cure was 53.3%. Conclusion : Gikwuibasin-tang is effective in the treatment of nocturnal enuretic children. Further study is needed with more cases.

• 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.18 no.1
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• pp.179-191
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• 2004

Objective: The aim of this study was to investigate enuretic children attending oriental hospital and classify subtypes and evaluate possible factors that enhance or hamper of continence. Methods: Children attending kyeongju dongguk oriental hospital pediatrics between January 2000 and December 2003 with chief complaint of nocturnal enuresis were enrolled. The data of present symptoms and improvement progress was collected via telephone interviews with their parents. Results: The total number of children was 61. 32 of them were male and 29 female. Sex ratio was 1.1:1. Patient under 6 years of age was 68.8%. Using acupuncture, acupressure or chimsband with herb medicine, treatment frequency was increased. Patients with nocturnal enuresis(NE) was 48, and primary nocturnal enuresis(PNE) 39, secondary (SNE) 9. 13 was impossible to diagnose. The ratio of male to female was 1:1.09. PNE was 4 times as many as SNE. Male was predominent in PNE, and female in SNE. In the progress of PNE, male and female were similiar. but SNE, male was all cured, female remained 50%. And elapsed time of male to improve was longer than that of female. In the progress of improvement, many parents mentioned that their child was improved spontaneously regardless of subtype. Conclusion: We consider age, sex distinction, subtype, bladder symptoms, frequency, time of progress as influencing factor of prognosis, but failed to verify significance. To develop guideline of NE and find influencing factor of prognosis, more prospective study through taking history carefully and using questionnaire is needed.

• 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.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.

• The Journal of Pediatrics of Korean Medicine
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• v.19 no.1
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• pp.103-115
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• 2005

Objectives : Nocturnal enuresis is common disorder in children and has important negative effects on the self-image and performance of children. Thus Successful treatment needed to increase self-esteem. Many studies of this symptoms were reported. But electro-acupuncture treatment not reported in Korea. Methods : We treated three cases enuretic children with different types. Their diagnosis were non-monosymptomatic primary, monosymptomatic primary, monosymptomatic secondary nocturnal enuresis. We used electro-acupuncture on Zhongji(CV3), Guanyuan(CV4) for 20 min. To investigate relapse. at least for 4 months after the end of the therapy we followed-up by telephone. Results : After treatment, diurnal urinary symptoms, such as increased frequency of urination, urgency, incontinence were dramatically improved. And the number of wet night decreased with nocturia and delayed wetting time. Compared to pre-treatment, findings, the number of wet nights decreased 80% or more. Conclusion : All of them tolerated electro-acupuncture well and kept reduction at least for 4 months follow-up. Further study is needed with more cases.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.1
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• pp.42-50
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• 2000

This study was designed to evaluate the emotional and behavioral problems of nocturnal enuresis children(n=72) in general population. And this was compared with normal control children(n=72). The behavioral problems were assessed using a modified child behavior checklist(CBCL) parent form. The results indicated that enuretic children were rated significantly more anxious, fearful, depressed, inattentive, hyperactive, delinquent on the modified CBCL rating when compared to the age-, grade- and sex-matched normal control children. Finally, it was an impressive evidence that there exist many emotional and behavioral problems in children with nocturnal enuresis.