Resultados de una estrategia terapéutica frente a la enuresis nocturna monosintomática

Rodríguez do Forno, A.; Ariceta Iraola, G.

doi:10.1016/S1695-4033(01)78647-X

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"apellidos" => "Grafiá Juan" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403301786468?idApp=UINPBA00005H" "url" => "/16954033/0000005400000001/v1_201307051535/S1695403301786468/v1_201307051535/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Resultados de una estrategia terapéutica frente a la enuresis nocturna monosintomática" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "38" "paginaFinal" => "43" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. Rodríguez do Forno, G. Ariceta Iraola" "autores" => array:2 [ 0 => array:3 [ "nombre" => "A." "apellidos" => "Rodríguez do Forno" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "G." "apellidos" => "Ariceta Iraola" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidades de Nefrología Pediátrica. Departamentos de Pediatría, Complexo Hospitalario Cristal-Piñor. Orense" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidades de Nefrología Pediátrica. Departamentos de Pediatría, Hospital Clínico Universitario. Santiago de Compostela" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Unidad de Nefrología Pediátrica. Departamento de Pediatría.Complexo Hospitalario Cristal-Piñor. Rua Ramón Puga, 54. 32005 Orense" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Results of a therapeutic strategy against monosymptomatic nocturnal enuresis" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-05-31" "fechaAceptado" => "2000-09-30" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186552" "palabras" => array:4 [ 0 => "nuresis nocturna monosintomática" 1 => "Desmopresina" 2 => "Oxibutinina" 3 => "Alarma" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186551" "palabras" => array:4 [ 0 => "onosymptomatic nocturnal enuresis" 1 => "Desmopressin" 2 => "Oxybutynin" 3 => "Alarm" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "AntecedentesLas opciones terapéuticas frente a la enuresis son múltiples. ObjetivoEvaluar diferentes terapias aplicadas de manera progresiva en la enuresis nocturna monosintomática. Pacientes y métodosSe estudiaron 84 pacientes enuréticos de 6 a 14 años de edad. Los niños de 6 a 7 años recibieron tratamiento con desmopresina, asociando en los no respondedores oxibutinina y posteriormente si continuaban mojando alarma. Los mayores de 7 años recibieron aleatoriamente tratamiento con alarma o con alarma más desmopresina; a los no respondedores se les trató con desmopresina. ResultadosEn los niños de 6-7 años el porcentaje acumulado de respuesta fue del 72 %. Los menos mojadores fueron los que respondieron a desmopresina. En los niños con edad superior a 7 años, la respuesta con alarma fue del 73,3% y del 58,6% en los tratados con alarma y desmopresina; la respuesta acumulada, tras la aplicación de desmopresina a los no respondedores, pasó a ser del 80 y 62 %, respectivamente. ConclusiónEn el grupo de 6-7 años la desmopresina está indicada como terapia inicial. La asociación con oxibutinina aumentó la eficacia del tratamiento, sobre todo en los niños más mojadores. En los mayores de 7 años es la alarma la terapia más efectiva y con menor número de recaídas, sin observarse una mejor respuesta al asociar desmopresina y alarma según nuestro protocolo." ] "en" => array:1 [ "resumen" => "BackgroundThere are many therapeutic options against enuresis. ObjectiveTo evaluate several therapies introduced progressively to treat monosymptomatic nocturnal enuresis. MethodsEighty-four patients, aged 6 to 14 years old, were studied. The 6-7 year olds were treated with desmopressin and oxybutynin was added in non-responders. If enuresis persisted, Alarm was given. Children over 7 years of age were randomly divided and treated with Alarm or Alarm plus desmopressin. Non-responders were treated with desmopressin alone. ResultsIn children aged 6-7 years the cumulative response was 72 %. Those who wetted themselves less responded to desmopressin. In children over 7 years of age, response to Alarm was 73.3% and response to Alarm plus desmopressin was 58.6 %. In non-responders the cumulative response after desmopressin treatment increased to 80 % and 62 % respectively." ] ] "bibliografia" => array:2 [ "titulo" => "Bibliogrífia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:22 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Establishment of working definitions in nocturnal enuresis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.J. Butler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child" "fecha" => "1991" "volumen" => "66" "paginaInicial" => "267" "paginaFinal" => "271" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2001119" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathophysiology and impact of nocturnal enuresis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K. Hjalmas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta-Paediatr" "fecha" => "1997" "volumen" => "86" "paginaInicial" => "919" "paginaFinal" => "922" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9343267" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Improvements in self-concept after treatment of nocturnal enuresis: Randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.E.K. Moffat" 1 => "C. Kato" 2 => "I.B. Pless" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Pediatr" "fecha" => "1987" "volumen" => "110" "paginaInicial" => "647" "paginaFinal" => "652" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3550026" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Self-esteem before and after treatment in children with nocturnal enuresis and urinary incontinence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B. Hagglof" 1 => "O. Andren" 2 => "E. Bergstrom" 3 => "L. Marklund" 4 => "M. Wendelius" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Scand J Urol Nephrol" "fecha" => "1997" "numero" => "Suppl) 183" "paginaInicial" => "79" "paginaFinal" => "82" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nocturnal enuresis: Economic impacts and self-esteem. Preliminary research results" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K. Pugner" 1 => "J. Holmes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Scand J Urol Nephrol" "fecha" => "1977" "numero" => "Suppl) 183" "paginaInicial" => "65" "paginaFinal" => "69" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7542400" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Editorial: Primary nocturnal enuresis. An analysis of factors related to its etiology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.S. Skoog" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "1998" "volumen" => "159" "paginaInicial" => "1338" "paginaFinal" => "1339" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9507880" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hyponatremia in patients with nocturnal enuresis treated with DDAVP" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "W.L. Robson" 1 => "J.P. Norgaard" 2 => "A.K. Leung" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Pediatr" "fecha" => "1996" "volumen" => "155" "paginaInicial" => "959" "paginaFinal" => "962" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8911897" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Concept of Outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Hunt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Scand J Urol Nephrol" "fecha" => "1997" "numero" => "Suppl) 183" "paginaInicial" => "71" "paginaFinal" => "74" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/368977" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The genetics of enuresis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Bakwin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Bladder control and enuresis" "paginaInicial" => "73" "paginaFinal" => "77" "serieFecha" => "1973" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical enuresis phenotypes in familial nocturnal enuresis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Von Gontard" 1 => "E. Hollmann" 2 => "H. Eiberg" 3 => "B. Benden" 4 => "S. Rittig" 5 => "G. Lehmkuhl" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Scand J Urol Nephrol" "fecha" => "1997" "numero" => "Suppl) 183" "paginaInicial" => "11" "paginaFinal" => "16" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6223363" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The influence of small funcional bladder capacity and others predictors on the response to desmopressine in the management of monosymptomatic nocturnal enuresis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H.G. Rushton" 1 => "A.B. Belman" 2 => "M.R. Zaontz" 3 => "S.J. Skoog" 4 => "S. Sihelnik" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "1996" "volumen" => "156" "paginaInicial" => "651" "paginaFinal" => "655" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8683752" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Desmopressin resistant enuresis: Pathogenetics and therapeutics considerations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Neveus" 1 => "G. Lackgren" 2 => "T. Tuvemo" 3 => "U. Olsson" 4 => "A. Stemberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "1999" "volumen" => "162" "paginaInicial" => "2136" "paginaFinal" => "2140" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10569604" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sit FKY. Bladder dysfunction in children with refractory monosymptomatic primary nocturnal enuresis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.K. Yeung" 1 => "H.N. Chiu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "1999" "volumen" => "162" "paginaInicial" => "1049" "paginaFinal" => "1055" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10458430" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of desmopressin and enuresis alarm for nocturnal enuresis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Wille" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Dis Child" "fecha" => "1986" "volumen" => "61" "paginaInicial" => "31" "paginaFinal" => "33" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Conditioning treatment of enuresis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C.G. Young" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Dev Med Child Neuro" "fecha" => "1965" "volumen" => "17" "paginaInicial" => "557" "paginaFinal" => "562" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Rappaport L Prognostic factors for alarm treatment" ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/00365590310008712" "Revista" => array:6 [ "tituloSerie" => "Scand J Urol Nephrol" "fecha" => "1997" "numero" => "Suppl) 183" "paginaInicial" => "55" "paginaFinal" => "57" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12745746" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary nocturnal enuresis: A comparison among observation, imipramine, desmopressin acetate and bed-wetting alarm systems" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.M. Monda" 1 => "D.A. Husmann" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "1995" "volumen" => "154" "paginaInicial" => "745" "paginaFinal" => "748" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7609169" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enuresis nocturna primaria monosintomática. Tratamiento con el aparato de alarma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "I. Pérez de Bustamante" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Urol Integr Invest" "fecha" => "1996" "volumen" => "1" "paginaInicial" => "87" "paginaFinal" => "89" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Combination Therapy for nocturnal enuresis with desmopressin and an alarm device" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Bradbury" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Scand J Urol Nephrol" "fecha" => "1997" "numero" => "Suppl) 183" "paginaInicial" => "61" "paginaFinal" => "63" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acetato de desmopresina (DDAVP) y enuresis nocturna: ¿Qué es lo que sabemos?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.E.K. Moffatt" 1 => "S. Harlos" 2 => "A.J. Kirshen" 3 => "L. Burd" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Pediatrics (ed esp.)" "fecha" => "1993" "volumen" => "36" "paginaInicial" => "127" "paginaFinal" => "132" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Desmopressin in nocturnal enuresis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Aladjem" 1 => "R. Whol" 2 => "H. Boichis" 3 => "S. Orda" 4 => "D. Lotan" 5 => "S. Freedman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child" "fecha" => "1982" "volumen" => "57" "paginaInicial" => "137" "paginaFinal" => "140" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7039520" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22." 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Evans" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "The Practitioner" "fecha" => "1992" "volumen" => "236" "paginaInicial" => "780" "paginaFinal" => "782" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1461876" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/16954033/0000005400000001/v1_201307051535/S169540330178647X/v1_201307051535/es/main.assets" "Apartado" => array:4 [ "identificador" => "14282" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/16954033/0000005400000001/v1_201307051535/S169540330178647X/v1_201307051535/es/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S169540330178647X?idApp=UINPBA00005H"]

Anales de Pediatría

ISSN: 1695-4033

La Asociación Española de Pediatría tiene como uno de sus objetivos principales la difusión de información científica rigurosa y actualizada sobre las distintas áreas de la pediatría. Anales de Pediatría es una revista de acceso abierto que actúa como el Órgano de Expresión Científica de la Asociación y constituye el vehículo a través del cual se comunican los asociados. Anales de Pediatría publica, en inglés y en español, trabajos originales sobre investigación en pediatría, así como artículos de revisión elaborados por los profesionales expertos de cada especialidad, y guías o documentos de posicionamiento elaborados por las diferentes Sociedades/Secciones Especializadas integradas en la Asociación Española de Pediatría. La revista, referente de la pediatría de habla española, está indexada en las más importantes bases de datos internacionales: Index Medicus/Medline IBECS, IME, SCOPUS, Science Citation Index Expanded, Journal Citations Report, Embase/Excerpta Medica, Directory of Open Access Journals (DOAJ).

In Memoriam: Alfredo García-Alix (1956-2024)

Indexada en:

Index Medicus/Medline IBECS, IME, SCOPUS, Science Citation Index Expanded, Journal Citations Report, Embase/Excerpta Medica, Directory of Open Access Journals (DOAJ)

Se estudiaron 84 pacientes enuréticos de 6 a 14 años de edad. Los niños de 6 a 7 años recibieron tratamiento con desmopresina, asociando en los no respondedores oxibutinina y posteriormente si continuaban mojando alarma. Los mayores de 7 años recibieron aleatoriamente tratamiento con alarma o con alarma más desmopresina; a los no respondedores se les trató con desmopresina.

Resultados

En los niños de 6-7 años el porcentaje acumulado de respuesta fue del 72 %. Los menos mojadores fueron los que respondieron a desmopresina. En los niños con edad superior a 7 años, la respuesta con alarma fue del 73,3% y del 58,6% en los tratados con alarma y desmopresina; la respuesta acumulada, tras la aplicación de desmopresina a los no respondedores, pasó a ser del 80 y 62 %, respectivamente.

Conclusión

En el grupo de 6-7 años la desmopresina está indicada como terapia inicial. La asociación con oxibutinina aumentó la eficacia del tratamiento, sobre todo en los niños más mojadores. En los mayores de 7 años es la alarma la terapia más efectiva y con menor número de recaídas, sin observarse una mejor respuesta al asociar desmopresina y alarma según nuestro protocolo.

Palabras clave:

nuresis nocturna monosintomática

Desmopresina

Oxibutinina

Alarma

Background

There are many therapeutic options against enuresis.

Objective

To evaluate several therapies introduced progressively to treat monosymptomatic nocturnal enuresis.

Methods

Eighty-four patients, aged 6 to 14 years old, were studied. The 6-7 year olds were treated with desmopressin and oxybutynin was added in non-responders. If enuresis persisted, Alarm was given. Children over 7 years of age were randomly divided and treated with Alarm or Alarm plus desmopressin. Non-responders were treated with desmopressin alone.

Results

In children aged 6-7 years the cumulative response was 72 %. Those who wetted themselves less responded to desmopressin. In children over 7 years of age, response to Alarm was 73.3% and response to Alarm plus desmopressin was 58.6 %. In non-responders the cumulative response after desmopressin treatment increased to 80 % and 62 % respectively.

Key words:

onosymptomatic nocturnal enuresis

Desmopressin

Oxybutynin

Alarm

El Texto completo está disponible en PDF

Bibliogrífia

[1.]

R.J. Butler.

Establishment of working definitions in nocturnal enuresis.

Arch Dis Child, 66 (1991), pp. 267-271

Medline

[2.]

K. Hjalmas.

Pathophysiology and impact of nocturnal enuresis.

Acta-Paediatr, 86 (1997), pp. 919-922

Medline

[3.]

M.E.K. Moffat, C. Kato, I.B. Pless.

Improvements in self-concept after treatment of nocturnal enuresis: Randomised controlled trial.

J Pediatr, 110 (1987), pp. 647-652

Medline

[4.]

B. Hagglof, O. Andren, E. Bergstrom, L. Marklund, M. Wendelius.

Self-esteem before and after treatment in children with nocturnal enuresis and urinary incontinence.

Scand J Urol Nephrol, (1997), pp. 79-82

[5.]

K. Pugner, J. Holmes.

Nocturnal enuresis: Economic impacts and self-esteem. Preliminary research results.

Scand J Urol Nephrol, (1977), pp. 65-69

Medline

[6.]

J.S. Skoog.

Editorial: Primary nocturnal enuresis. An analysis of factors related to its etiology.

J Urol, 159 (1998), pp. 1338-1339

Medline

[7.]

W.L. Robson, J.P. Norgaard, A.K. Leung.

Hyponatremia in patients with nocturnal enuresis treated with DDAVP.

Eur J Pediatr, 155 (1996), pp. 959-962

Medline

[8.]

S. Hunt.

The Concept of Outcome.

Scand J Urol Nephrol, (1997), pp. 71-74

Medline

[9.]

H. Bakwin.

The genetics of enuresis.

Bladder control and enuresis, pp. 73-77

[10.]

A. Von Gontard, E. Hollmann, H. Eiberg, B. Benden, S. Rittig, G. Lehmkuhl.

Clinical enuresis phenotypes in familial nocturnal enuresis.

Scand J Urol Nephrol, (1997), pp. 11-16

Medline

[11.]

H.G. Rushton, A.B. Belman, M.R. Zaontz, S.J. Skoog, S. Sihelnik.

The influence of small funcional bladder capacity and others predictors on the response to desmopressine in the management of monosymptomatic nocturnal enuresis.

J Urol, 156 (1996), pp. 651-655

Medline

[12.]

T. Neveus, G. Lackgren, T. Tuvemo, U. Olsson, A. Stemberg.

Desmopressin resistant enuresis: Pathogenetics and therapeutics considerations.

J Urol, 162 (1999), pp. 2136-2140

Medline

[13.]

C.K. Yeung, H.N. Chiu.

Sit FKY. Bladder dysfunction in children with refractory monosymptomatic primary nocturnal enuresis.

J Urol, 162 (1999), pp. 1049-1055

Medline