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Year : 2022  |  Volume : 5  |  Issue : 2  |  Page : 69-77

Evidence based management of primary monosymptomatic nocturnal enuresis

1 Division of Nephrology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
2 Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

Correspondence Address:
Girish Chandra Bhatt
Room No. 1023, 1st Floor, Academic Block, AIIMS Hospital, Saket Nagar, Bhopal - 462 020, Madhya Pradesh
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Source of Support: None, Conflict of Interest: None

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Nocturnal enuresis refers to bedwetting at night or during sleep. It may be either primary or have a complex presentation due to secondary etiologies. It is essential to differentiate primary enuresis from secondary enuresis, and monosymptomatic enuresis from polysymptomatic monosymptomatic enuresis, to guide therapy. For primary monosymptomatic enuresis, bladder training, urotherapy, alarm therapy, and desmopressin have been the mainstay of treatment. Choosing a suitable therapy for nocturnal enuresis warrants a thorough review of symptoms and voiding diary. Additionally, certain pretreatment and posttreatment response predictors have been found useful in management. Subclassification of primary monosymptomatic enuresis through bladder diary or ultrasonography helps select suitable candidates for anticholinergic therapy, which was previously reserved for refractory enuresis. The aim of this review is to integrate newer approaches with conventional therapy in diagnosing, classifying, and selecting therapies for nocturnal enuresis. Search Strategy: MeSH analysis was done on NCBI Platform with “enuresis” as MeSH major topic with several subtopics. The input for search builder was: (”Enuresis/classification”[Mesh] OR “Enuresis/diagnosis”[Mesh] OR “Enuresis/diagnostic imaging”[Mesh] OR “Enuresis/diet therapy”[Mesh] OR “Enuresis/prevention and control”[Mesh] OR “Enuresis/therapy”[Mesh])) AND (”Enuresis/etiology”[Mesh] OR). Six hundred and fifty-seven results were found from 75 clinical trials, 28 systematic reviews, and 4 review articles that were used to synthesize this review.

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