Principles of therapy selection for enuresis in children and adolescents.

Abstract

Introduction. The problem of enuresis to this day remains relevant primarily in connection with a decrease in the quality of life of both children, due to psychological discomfort, and their parents. The aim of the study was to select effective algorithms for the diagnosis and treatment of nocturnal enuresis in children and adolescents, taking into account the pathogenesis of the disease. Materials and methods. Children aged 5 to 15 years with a clinically confirmed diagnosis of enuresis were selected for the study. Depending on the clinical form of the disease, the children were divided into three groups. The first group included patients with the primary form of enuresis, the second-with secondary enuresis, and the third-with a mixed form of the disease. After an additional examination, all patients were assigned treatment based on their clinical group. Patients of the first clinical group were prescribed desmopressin as a treatment. In the second clinical group, treatment was carried out taking into account the level of damage to the nervous system. In the case of a suspected lesion of the cervical spine, electrophoresis was performed with a 1% solution of Euphyllini with an electrode applied to the cervical region. Nootropics and group B vitamins were prescribed for suspected cerebral lesions. In hyperexcitability syndrome, patients received Тenoten for children. In the third clinical group, treatment was carried out in two stages. The first stage corresponded to the protocol of treatment of the secondary form of enuresis, was carried out in a hospital setting. Further treatment was carried out on an outpatient basis in accordance with the recommendations for the treatment of the primary form of enuresis. Results. Positive dynamics was observed in all three clinical groups after the treatment. In 2.7% of children, a clinical cure was observed after the first course of therapy. 71.8% have a complete recovery after two courses of therapy. In 17.3% – after three courses of treatment. Conclusion. Principles of therapy selection for enuresis in children and adolescents require a comprehensive diagnosis and careful selection of therapy, depending on the pathogenetic form. The current control of therapy can be carried out by a pediatrician, and the intermediate results of treatment should be evaluated by a neurologist and a urologist. Hospitalization in a hospital is indicated in the case of the development of concomitant complications in the form of urinary tract infection, infectious and urodynamic disorders.