Медицинский Совет

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Недержание мочи является распространенной проблемой детского возраста. В структуре расстройств произвольного мочеиспускания в детском возрасте ведущее место занимает изолированный (моносимптомный) ночной энурез. В статье представлена современная классификация моносимптомного ночного энуреза; приводится характеристика возможных патогенетических механизмов его развития. Подробно рассмотрены алгоритмы диагностики и вопросы немедикаментозной и медикаментозной терапии.

Об авторах

И. Н. Захарова
Российская медицинская академия непрерывного профессионального образования Минздрава России, Москва
д.м.н., профессор

Э. Б. Мумладзе
Российская медицинская академия непрерывного профессионального образования Минздрава России, Москва

И. И. Пшеничникова
Российская медицинская академия непрерывного профессионального образования Минздрава России, Москва

Список литературы

1. Nevéus T et al. The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children’s Continence Society. The Journal of urology, 2006, 176(1): 314-324.

2. Von Gontard A et al. Clinical behavioral problems in day-and night-wetting children. Pediatric Nephrology, 1999, 13(8): 662-667.

3. Neveus T et al. Evaluation of and treatment for monosymptomatic enuresis: a standardization document from the International Children’s Continence Society. The Journal of urology, 2010, 183(2): 441-447.

4. Koff S. Enuresis. In: Campbell’s Urology, 7th ed, Walsh, P, Retik, A Jr, et al (Eds), WB Saunders, Philadelphia, 1998. p. 2055.

5. Rushton HG. Wetting and functional voiding disorders. The Urologic clinics of North America, 1995, 22(1): 75-93.

6. Feng WC, Churchill BM. Dysfunctional elimination syndrome in children without obvious spinal cord diseases. Pediatric Clinics of North America, 2001, 48(6): 1489-1504.

7. Fergusson DM, Horwood LJ, Shannon FT. Factors related to the age of attainment of nocturnal bladder control: an 8-year longitudinal study. Pediatrics, 1986, 78(5): 884-890.

8. Bakker E et al. Voiding habits and wetting in a population of 4332 Belgian schoolchildren aged between 10 and 14 years. Scandinavian journal of urology and nephrology, 2002, 36(5): 354-362.

9. Howe AC, Walker CE. Behavioral management of toilet training, enuresis, and encopresis. Pediatric Clinics of North America, 1992, 39(3): 413.

10. Forsythe WI, Redmond A. Enuresis and spontaneous cure rate study of 1129 enuretics. Archives of Disease in Childhood, 1974, 49(4): 259-263.

11. Klacenberg G. Nocturnal enuresis in a longitudinal perspective. Acta Paediatrica, 1981, 70(4): 453-457.

12. Esperanca M, Gerrard JW. Nocturnal enuresis: studies in bladder function in normal children and enuretics. Canadian Medical Association Journal, 1969, 101(6): 324.

13. Bloom DA et al. Toilet habits and continence in children: an opportunity sampling in search of normal parameters. The Journal of urology, 1993, 149(5): 1087-1090.

14. Mota DM, Barros AJ. Toilet training: methods, parental expectations and associated dysfunctions. Jornal de pediatria, 2008, 84(1): 9.

15. Stadtler AC, Gorski PA, Brazelton TB. Toilet training methods, clinical interventions, and recommendations. Pediatrics, 1999, 103(Suppl. 3): 1359-1361.

16. Wille S. Primary nocturnal enuresis in children. Background and treatment. Scandinavian journal of urology and nephrology. Supplementum, 1993, 156: 1-48.

17. Nørgaard JP, Djurhuus JC. The pathophysiology of enuresis in children and young adults. Clinical pediatrics, 1993, 32(Suppl. 1): 5-9.

18. Nørgaard JP. Pathophysiology of nocturnal enuresis. Scandinavian journal of urology and nephrology. Supplementum, 1990, 140: 1-35.

19. Neveus T, Eggert P, Evans J et al. Evaluation of and treatment for monosymptomatic enuresis: a standardization document from the International Children’s Continence Society. J Urol, 2010, 183: 441.

20. Baker BL. Symptom treatment and symptom substitution in enuresis. Journal of Abnormal Psychology, 1969, 74(1): 42.

21. Young GC, Morgan RT. Conditioning techniques and enuresis. The Medical journal of Australia, 1973, 2(7): 329.

22. Longstaffe S, Moffatt ME, Whalen JC. Behavioral and self-concept changes after six months of enuresis treatment: a randomized, controlled trial. Pediatrics, 2000, 105: 935.

23. Järvelin MR. Developmental history and neurological findings in enuretic children. Developmental Medicine & Child Neurology, 1989, 31(6): 728-736.

24. Light L. Children with enuresis. Most cases of primary nocturnal enuresis are caused by isolated developmental immaturity. BMJ (Clinical research ed.), 1998, 316(7133): 777-778.

25. Koff SA. Cure of nocturnal enuresis: why isn’t desmopressin very effective? Pediatric Nephrology, 1996, 10(5): 667-670.

26. Järvelin MR et al. Aetiological and precipitating factors for childhood enuresis. Acta Paediatrica, 1991, 80(3): 361-369.

27. Von Gontard A et al. Neuromotor development in nocturnal enuresis. Developmental Medicine & Child Neurology, 2006, 48(09): 744-750.

28. Iscan A et al. Abnormalities in event-related potential and brainstem auditory evoked response in children with nocturnal enuresis. Brain and Development, 2002, 24(7): 681-687.

29. Freitag CM et al. Neurophysiology of nocturnal enuresis: evoked potentials and prepulse inhibition of the startle reflex. Developmental Medicine & Child Neurology, 2006, 48(04): 278-284.

30. Watanabe H, Azuma YA. Proposal for a classification system of enuresis based on overnight simultaneous monitoring of electroencephalography and cystometry. Sleep: Journal of Sleep Research & Sleep Medicine. 1989.

31. Bakwin H. Enuresis in twins. Am J Dis Child, 1971, 121: 222.

32. Bakwin H. The genetics of enuresis. Bladder control and enuresis, 1973: 73-77.

33. Eiberg H, Berendt I, Mohr J. Assignment of dominant inherited nocturnal enuresis (ENUR1) to chromosome 13q. Nature genetics, 1995, 10(3): 354-356.

34. Loeys B et al. Does monosymptomatic enuresis exist? A molecular genetic exploration of 32 families with enuresis/incontinence. BJU international, 2002, 90(1): 76-83.

35. Muellner SR. Development of urinary control in children: some aspects of the cause and treatment of primary enuresis. Journal of the American Medical Association, 1960, 172(12): 1256-1261.

36. Starfield B. Functional bladder capacity in enuretic and nonenuretic children. The Journal of pediatrics, 1967, 70(5): 777-781.

37. Wu HH et al. Urodynamic studies in primary nocturnal enuresis. Zhonghua Yi Xue Za Zhi. Chinese medical journal, Free China ed, 1988, 41(3): 227-232.

38. Vulliamy D. The day and night output of urine in enuresis. Archives of disease in childhood, 1956, 31(160): 439.

39. Robson WL. Clinical practice. Evaluation and management of enuresis. N Engl J Med., 2009 Apr 2, 360(14): 1429-36.

40. Troup CW, Hodgson NB. Nocturnal functional bladder capacity in enuretic children. Wisconsin medical journal, 1971, 70(7): 171-173.

41. Kawauchi A et al. Bladder capacity at the time of enuresis. Urology, 2003, 61(5): 1016-1018.

42. Poulton EM. Relative nocturnal polyuria as a factor in enuresis. The Lancet, 1952, 260(6741): 906-907.

43. Rasmussen PV et al. Enuresis nocturna can be provoked in normal healthy children by increasing the nocturnal urine output. Scandinavian journal of urology and nephrology, 1996, 30(1): 57-61.

44. Robson WL. Evaluation and management of enuresis. New England Journal of Medicine, 2009, 360(14): 1429-1436.

45. Aikawa T, Kasahara T, Uchiyama M. The arginine-vasopressin secretion profile of children with primary nocturnal enuresis. European urology, 1998, 33(Suppl. 3): 41-44.

46. Rittig S et al. Diurnal variation of plasma atrial natriuretic peptide in normals and patients with enuresis nocturna. Scandinavian journal of clinical and laboratory investigation, 1991, 51(2): 209-217.

47. Pomeranz A et al. Night-time polyuria and urine hypo-osmolality in enuretics identified by nocturnal sequential urine sampling: Do they represent a subset of relative ADH-deficient subjects? Scandinavian journal of urology and nephrology, 2000, 34(3): 199-202.

48. Aceto G et al. Sodium fraction excretion rate in nocturnal enuresis correlates with nocturnal polyuria and osmolality. The Journal of urology, 2004, 171(6): 2567-2570.

49. Rittig S et al. The circadian defect in plasma vasopressin and urine output is related to desmopressin response and enuresis status in children with nocturnal enuresis. The Journal of urology, 2008, 179(6): 2389-2395.

50. Yeung CK, Sit FK, To LK et al. Reduction in nocturnal functional bladder capacity is a common factor in the pathogenesis of refractory nocturnal enuresis. BJU Int, 2002, 90: 302.

51. George CPL et al. Diurnal Variation of Plasma Vasopressin in Man. The Journal of Clinical Endocrinology & Metabolism, 1975, 41(2): 332-338.

52. Kawauchi A et al. Development of bladder capacity, nocturnal urinary volume and urinary behavior in nonenuretic and enuretic children. Nihon Hinyokika Gakkai zasshi. The japanese journal of urology, 1993, 84(10): 1811-1820.

53. Kawauchi A, Watanabe H, Miyoshi K. Early morning urine osmolality in nonenuretic and enuretic children. Pediatric Nephrology, 1996, 10(6): 696-698.

54. Yeung CK, Chiu HN, Sit FK. Bladder dysfunction in children with refractory monosymptomatic primary nocturnal enuresis. The Journal of urology, 1999, 162(3): 1049-1054.

55. Nørgaard JP et al. Simultaneous registration of sleep-stages and bladder activity in enuresis. Urology, 1985, 26(3): 316-319.

56. Nørgaard JP. Urodynamics in enuretics I: reservoir function. Neurourology and Urodynamics, 1989, 8(3): 199-211.

57. Nörgaard JP. Urodynamics in enuretics II: a pressure/flow study. Neurourology and Urodynamics, 1989, 8(3): 213-217.

58. Van Hoeck K et al. Urine output rate and maximum volume voided in school-age children with and without nocturnal enuresis. The Journal of pediatrics, 2007, 151(6): 575-580.

59. Nørgaard JP et al. Nocturnal studies in enuretics. A polygraphic study of sleep-EEG and bladder activity. Scandinavian journal of urology and nephrology. Supplementum, 1988, 125: 73-78.

60. Nørgaard JP et al. Sleep cystometries in children with nocturnal enuresis. The Journal of urology, 1989, 141(5): 1156-1159.

61. Broughton RJ. Sleep disorders: disorders of arousal? Science, 1968, 159(3819): 1070-1078.

62. Wille S. Nocturnal enuresis: sleep disturbance and behavioural patterns. Acta Paediatr, 1994, 83: 772.

63. Nevéus T, Hetta J, Cnattingius S et al. Depth of sleep and sleep habits among enuretic and incontinent children. Acta Paediatr, 1999, 88: 748.

64. Wolfish NM, Pivik RT, Busby KA. Elevated sleep arousal thresholds in enuretic boys: clinical impli cations. Acta paediatrica, 1997, 86(4): 381-384.

65. Hunsballe JM. Increased delta component in computerized sleep electroencephalographic analysis suggests abnormally deep sleep in primary monosymptomatic nocturnal enuresis. Scandinavian journal of urology and nephrology, 2000, 34(5): 294-302.

66. Yeung CK, Diao M, Sreedhar B. Cortical arousal in children with severe enuresis. New England Journal of Medicine, 2008, 358(22): 2414-2415.

67. Ritvo ER et al. Arousal and nonarousal enuretic events. American Journal of Psychiatry, 1969, 126(1): 77-84.

68. Bader G et al. Sleep of primary enuretic children and controls. Sleep, 2002, 25(5): 579-583.

69. Nevéus T et al. Sleep of children with enuresis: a polysomnographic study. Pediatrics, 1999, 103(6): 1193-1197.

70. Wille S, Anveden I. Social and behavioural perspectives in enuretics, former enuretics and non‐enuretic controls. Acta Paediatrica, 1995, 84(1): 37-40.

71. Joinson C et al. A United Kingdom populationbased study of intellectual capacities in children with and without soiling, daytime wetting, and bed-wetting. Pediatrics, 2007, 120(2): 308-316.

72. Hägglöf B et al. Self-esteem before and after treatment in children with nocturnal enuresis and urinary incontinence. Scandinavian journal of urology and nephrology. Supplementum, 1996, 183: 79-82.

73. Baeyens D et al. Attention deficit/hyperactivity disorder in children with nocturnal enuresis. The Journal of urology, 2004, 171(6): 2576-2579.

74. Nevéus T. Diagnosis and management of nocturnal enuresis. Current opinion in pediatrics, 2009, 21(2): 199-202.

75. Малых А.Л., Захарова И.Н., Пыков М.И. Энурез у подростков и призывников: современные подходы к диагностике. Педиатрическая фармакология, 2014, 11(1).

76. Балева Л.С., Казанская И.В., Коровина Н.А., Студеникин В.М., Блистинова З.А., Заваденко Н.Н., Захарова И.Н., Тамазян Г.В. Алгоритм диагностики и лечения первичного ночного энуреза у детей. Вопросы современной педиатрии, 2005, 4(2).

77. Salle JL et al. Magnetic resonance imaging in children with voiding dysfunction: is it indicated? The Journal of urology, 1998, 160(3): 1080-1083.

78. Коровина Н.А., Гаврюшова Л.П., Захарова И.Н. Энурез у детей. Москва. Руководство для врачей. 2000. 33 с.

79. Гаврюшова Л.П., Коровина Н.А., Захарова И.Н. Энурез в детском возрасте. Москва. Пособие для практических врачей педиатров. 2008. 39 с.

80. Студеникин В. М. Терапия первичного ночного энуреза у детей с позиции доказательной медицины (данные литературы). Вопр. совр. Педиатрии, 2005, 4(6): 65-69.

81. Длин В.В., Морозов С.Л., Гусева Н.Б. Эффективность минирина у детей с нарушениями мочеиспускания. Эффективная фармакотерапия, 2014, 16: 12-16.

82. Robson WL, Leung AK, Norgaard JP. The comparative safety of oral versus intranasal desmopressin for the treatment of children with nocturnal enuresis. J. Urol., 2007, 178: 24-30.

83. Заваденко Н.Н., Колобова H.М. Энурез у детей: поиск новых подходов к проблеме. Вопросы современной педиатрии, 2004, 3(5).

84. Бородин В.И., Будтуева Ф.С. Место Пантокальцина® в комплексной терапии энуреза у детей. Здоровье ребенка, 2006, 3: 3.

Для цитирования:

Захарова И.Н., Мумладзе Э.Б., Пшеничникова И.И. ЭНУРЕЗ В ПРАКТИКЕ ПЕДИАТРА. Медицинский Совет. 2017;(1):172-179.

For citation:

Zakharova I.N., Mumladze E.B., Pshenichnikova I.I. Enuresis in pediatric practice. Medical Council. 2017;(1):172-179. (In Russ.)

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