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| 2. |
- Lundmark, Elisabet, et al.
(author)
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Reboxetine in therapy-resistant enuresis : a retrospective evaluation
- 2009
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In: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 43:5, s. 365-368
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Imipramine is the only evidence-based treatment available for enuretic children resistant to standard therapy. The drug's antienuretic effect is probably due to noradrenergic facilitation. The drug is, however, potentially cardiotoxic. In this study, the non-cardiotoxic noradrenergic antidepressant reboxetine was tested as an alternative to imipramine. PATIENTS AND METHODS: 61 patients, aged 7-19 years, with enuresis-resistant to desmopressin, the alarm, urotherapy and anticholinergics, were given 4-8 mg reboxetine at bedtime, if necessary combined with desmopressin. RESULTS: 32 patients became dry on reboxetine treatment, although 21 of them required combination treatment with desmopressin to achieve this. Eighteen children did not respond and eight children discontinued because of side-effects before treatment could be evaluated. No serious adverse events occurred. CONCLUSIONS: These results need to be confirmed with randomized controlled studies, but indicate that reboxetine will become a safe and efficient treatment alternative for enuretic children resistant to standard therapy.
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| 4. |
- Läckgren, Göran, et al.
(author)
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Non-neuropathic bladder-spincter dysfunction
- 2006. - 2
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In: Pediatric Surgery and Urology. - Cambridge : Cambridge University Press. - 9780521839020 ; , s. 643-651
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Book chapter (other academic/artistic)
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| 5. |
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| 6. |
- Nevéus, Tryggve
(author)
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Diagnosis and management of nocturnal enuresis
- 2009
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In: Current opinion in pediatrics. - 1040-8703 .- 1531-698X. ; 21:2, s. 199-202
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Research review (peer-reviewed)abstract
- PURPOSE OF REVIEW: To highlight recent advances in enuresis research. RECENT FINDINGS: Many discoveries have distanced us from the time when bedwetting was considered a psychiatric disorder. Instead, it is now agreed that nocturnal polyuria, detrusor overactivity, and high arousal thresholds are, in various combinations, central to enuresis pathogenesis. All three mechanisms have been further elucidated during the last year. It has been found that solute diuresis, and not just free-water diuresis due to vasopressin deficiency, may be causative. Sonographical bladder wall measurements have been shown to have prognostic value in detrusor-dependent enuresis, and fascinating proof for the interplay between the bladder and the sleeping brain has been put forward. And, ironically, sleep research has caused psychiatry to make a slight comeback, as studies have indicated that enuretic children may suffer from cognitive problems due to suboptimal sleep. Less has been achieved regarding treatment, but some evidence has finally supported the experience that anticholinergics may be effective in therapy-resistant enuresis. SUMMARY: During the last years, increased insight has been gained into the multifaceted pathogenesis of enuresis, but there is still an irritating lack of proven effective therapies.
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| 7. |
- Nevéus, Tryggve, et al.
(author)
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Diuretic treatment of nocturnal enuresis
- 2005
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In: Scand J Urol Nephrol. - 0036-5599. ; 39:6, s. 474-8
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Nocturnal polyuria is considered a major pathogenetic factor in nocturnal enuresis, and the antidiuretic drug desmopressin, given at bed-time, is consequently recognized as a first-line treatment alternative. The aim of this open, non-randomized study was to see whether diuretic medication, given in the afternoon, could give similar therapeutic benefit. MATERIAL AND METHODS: Sixty-three children suffering from primary, monosymptomatic, nocturnal enuresis were included in the study by their primary care paediatrician. After 14 days without any treatment and 14 days for which 0.4 mg of desmopressin was given orally at bed-time, the children were given furosemide 1 mg/kg in the afternoon for 14 consecutive days. The numbers of wet and dry nights were recorded. RESULTS: The numbers of wet nights at baseline, during desmopressin treatment and during furosemide treatment were 10.2+/-3.5, 6.4+/-4.6 and 8.2+/-4.5, respectively. Both drugs were significantly better than no treatment, but only a small proportion of patients became completely dry: 24% on desmopressin and 12% on furosemide. Desmopressin was significantly better than furosemide. Three children who showed no therapeutic effect on desmopressin treatment had a favourable response to furosemide. CONCLUSION: Furosemide, given in the afternoon, has minor therapeutic potential in nocturnal enuresis.
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| 10. |
- Nevéus, Tryggve
(author)
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Enuretic sleep : deep, disturbed or just wet?
- 2008
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In: Pediatric nephrology (Berlin, West). - : Springer Science and Business Media LLC. - 0931-041X .- 1432-198X. ; 23:8, s. 1201-2
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Journal article (peer-reviewed)abstract
- Enuretic children sleep "deeply" in the sense that they are difficult to arouse from sleep, but not in the sense that their sleep is necessarily polysomnographically different from other children. The enuretic children's arousal difficulties may be due to a disturbance at the brainstem level and/or to frequent arousal stimuli from the bladder. It may be hypothesised that the sleep disturbance of enuretic children may lead not only to the wetting of the sheets but to disturbances of daytime psychological functioning as well.
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| 11. |
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| 12. |
- Nevéus, Tryggve, et al.
(author)
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Nocturnal enuresis
- 2007. - 2
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In: Pediatric Urology. - Philadelphia : Saunders Elsevier. - 9781416032045
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Book chapter (other academic/artistic)
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| 13. |
- Nevéus, Tryggve
(author)
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Nocturnal enuresis
- 2009. - 2
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In: Pediatric Urology. - Philadelphia/London : Saunders. - 9781416032045 ; , s. 380-385
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Book chapter (other academic/artistic)
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| 20. |
- Nevéus, Tryggve, et al.
(author)
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Tolterodine and imipramine in refractory enuresis; a placebo-controlled crossover study
- 2008
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In: Pediatric nephrology (Berlin, West). - : Springer Science and Business Media LLC. - 0931-041X .- 1432-198X. ; 23:2, s. 263-267
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Journal article (peer-reviewed)abstract
- The anticholinergic drug tolterodine has been suggested to be useful in therapy-resistant enuresis. Imipramine has a proven efficiency in unselected enuretic patients, but due to its side-effect profile it is only indicated, if at all, in therapy-resistant cases. We therefore compared these two drugs to placebo. Twenty-seven children with enuresis resistant to the alarm and to desmopressin in monotherapy were given placebo, tolterodine 1-2 mg, and imipramine 25-50 mg at bedtime for 5 weeks each in a randomised, double-blind, crossover fashion. The number of wet nights during the last 2 weeks of each treatment period was compared. One patient became spontaneously dry at the start of the study, and one dropped out due to side effects. Among the remaining 25 children, the number of wet nights during placebo, tolterodine and imipramine treatment were 11.0 +/- 3.9, 10.4 +/- 3.9 and 7.8 +/- 5.1, respectively (p < 0.001). Imipramine was significantly better than both placebo (p=0.001) and tolterodine (p=0.006). Nine children experienced side effects on imipramine and one on tolterodine (p=0.001). This is the first study on anticholinergics or imipramine in children with therapy-resistant enuresis. Tolterodine, in monotherapy, had no proven effect. Imipramine was better than placebo, but side effects were common.
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