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Monosymptomatic and Non-monosymptomatic Enuresis

Telma Francisco1

1 - Unidade de Nefrologia Pediátrica, Hospital de Dona Estefânia, CHULC, EPE

- CS Educational Course on Bladder Dysfunction and Incontinence, Workshop on Urodynamics and Urotherapy and I Luso-Brazilian Meeting in Enuresis and Bladder Dysfunction (Lisboa), 29-30/Maio/2018 (Palestra)

Resumo: Enuresis is defined as any wetting that occurs in discrete amounts at night, regardless of whether it is associated with daytime symptoms. Causes may be organic or, more frequently, functional. Functional urinary incontinence may be classified into non-monossymptomatic enuresis, monossymptomatic enuresis and bladder dysfunction with diurnal symptoms. Non-monosymptomatic enuresis consists of loss of urine during the night, with day-time symptoms, while in monosymptomatic enuresis loss of urine occurs exclusively at night, without other symptoms or diurnal complaints. Bladder dysfunction includes several diagnoses: hyperactive bladder, micturition delay and hipoactive bladder and non-coordenated micturition. Enuresis may have several psychiatric and neurodevelopmental comorbidies: socialization problems, attention deficit and hyperactivity disorder, anxiety, depression, sleep problems and developmental disorders (language specific disorder, motor function disorders). Diagnosis and initiation of therapy are based on anamnesis and a non-invasive baseline assessment and includ exclusion of organic disease, classification into one of the functional categories (if applicable) and identification of comorbidities. Motivation is the most important factor determining success of treatment. Patient, family and healthcare professionals should work as a team. Urotherapy is the cornerstone of treatment and constipation and day-time symptoms should be treated before enuresis. Treatment should also be directed to the underlying pathology: vasopressin in nocturnal polyuria and alarm in decreased bladder capacity. 

Palavras Chave: monosymptomatic enuresis, non-monosymptomatic enuresis, urinary incontinence