Uitwerking Richtsnoer 'Enuresis nocturna' voor kinderen met hardnekkige klachten
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Richtlijnen
07-01-2004
R.A. Hira Sing, F.J.M. van Leerdam, R.N. Sukhai, J.W. van Capelle, F.M.J.A. Froeling en M.A.W. Vijverberg

Further development of 'Enuresis nocturna' guidelines for children with persistent problems

- To achieve dryness in children who suffer from persistent bedwetting, it is important to find out which factors play a role in their bedwetting and why previous treatment has failed. The use of a micturition diary is essential.

- The child's problems and needs have to be identified and treated individually. The enuresis alarm, with the proper guidance, is the preferred form of initial treatment.

- Desmopressin is particularly suitable in cases of nocturnal polyuria or if the use of the alarm is unfeasible.

- If the alarm does not have any effect within two weeks or if a rapid result is important, a combination of desmopressin and the alarm is advisable.

- Bedwetting combined with daytime micturition problems is often indicative of a small bladder capacity and/or detrusor instability. In these children bladder training and/or treatment with an anticholinergic drug (possibly combined with desmopressin) may be effective.