Table of Contents

HK J Paediatr (New Series)
Vol 7. No. 1, 2002

HK J Paediatr (New Series) 2002;7:39-45

Occasional Survey

What Do We Know About Childhood Nocturnal Enuresis ?

SN Wong


Primary nocturnal enuresis refers to persistent bedwetting beyond the age of five years. It is a common problem. Its exact causation is unknown but is believed to involve bladder dysfunction, nocturnal polyuria and impaired sleep arousal. Most resolve spontaneously with age. However, children with PNE may have psycho-behavioural problems and their parents experience greater stress. Treatment should be individualised depending on patient and family preference, presence of daytime symptoms or nocturnal polyuria. Recent meta-analysis suggested that alarm therapy, if properly used, has the best long term success. Desmopressin given intranasally or orally provides good symptomatic relief, giving it a role in gaining initial confidence of the family, ensuring dry nights when sleeping out, or when alarms therapy is not successful or contraindicated, or perhaps for those with nocturnal polyuria. Tricyclic antidepressants are as effective as desmopressin but best avoided because of potential risk of fatal poisoning to patients and siblings.

原發性夜間遺尿(PNE)是指五歲以後持續性尿床。這是一個較常見的問題。儘管其確切的病因尚不清楚,但通常認為與膀胱功能不良,夜間多尿和睡眠喚醒障礙有關。大部分患兒隨年齡增長自發緩解。但是 PNE 患兒可能伴有心理-行為問題,他們的家屬也承受較大的心理壓力。治療需根據患兒及家屬的習慣,日間的症狀或夜間多尿的情況,因人而異。最近的彙萃分析表明警報療法,如果應用得當,有最佳的遠期療效。當患兒在外露宿,或者警報療法不成功或有某些藥物的禁忌徵狀時,鼻腔內給藥或口服 Desmopressin 能有效地緩解症狀,確保夜間乾爽,建立起患兒和家屬的信心。此外 Desmopressin 可能對那些夜間多尿的患者也有療效。三環類抗抑鬱藥物與 Desmopressin 同樣有效,但須慎用因為它對患兒及其兄弟姊妹有潛在的致命毒性作用。

Keyword : Desmopressin; Enuretic alarm therapy; Primary nocturnal enuresis; Tricyclic antidepressant

關鍵詞:原發性夜間遺尿、遺尿警報療法、 Desmopressin、三環類抗抑鬱藥物


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