About primary nocturnal enuresis

Primary nocturnal enuresis (PNE) is widespread, and is the most common chronic ailment in children besides allergic disorders,1 affecting approximately 16% of 5-year-old children.2

PNE is a distressing condition that can have a significant impact on a young person’s behaviour and their emotional and social wellbeing.3,4

  • 32.5% of children (aged 9) rated wetting the bed as a ‘quite difficult’ life event for them 4
  • They rated bedwetting to be comparable to how they felt about being teased or not being able to spell properly 4

The burden of PNE on children and their families is considerable.5

PNE can be a persistent problem, and 10% of enuretic children will remain bedwetters for life.1

 

Enuretic symptoms in adolescent subjects were more severe than those in children.2 This shows early intervention can be key in PNE.

CAUSES

Most cases of PNE have two main causes:

Neurological-developmental delay
This is the most common cause of bedwetting. Most bedwetting children are delayed in developing the ability to stay dry and have no other developmental issues.2,6 Bedwetting may be due to a nervous system that is slow to process the feeling of a full bladder. 1,7

Genetics
Bedwetting has a strong genetic component. Children whose parents were not enuretic have a 15% incidence of bedwetting. However, when one or both parents were enuretic, the rates jump to 44% and 77% respectively8

It is generally accepted that there are three principle physiological aetiologies:1,9

  • Excessive night-time urine volume
    Due to low vasopressin levels, and subsequently, a reduced or absent nightly spike in vasopressin concentration which normally keeps bladder volume from reaching capacity until morning 1,9
  • Poor sleep arousal
    If the child does not wake at the feeling of a full bladder, the child will more likely wet the bed1,9
  • Bladder contraction
    The muscles of the bladder can suddenly contract before the bladder is full9

Nocturnal enuresis (NE) is also linked to one (or a combination) of the following factors: anxiety, stress, small bladder size, constipation, and urinary tract infection.7

DIAGNOSIS AND MANAGEMENT

A child’s treatment plan depends on:10

  • How often they are wetting the bed
  • The impact that bedwetting is having, on the child and their family members
  • The child’s sleeping arrangements
  • Whether there is a short-term need to control a child’s bedwetting
  • How the child feels about specific treatments

The burden of PNE on children and their families is significant;5 however, effective treatment benefits all parties.Click here to download the Clinical Management Tool to help you manage your patients with NE.

 

Prescribing Information and Adverse Event Reporting

DesmoMelt prescribing information can be downloaded here. Alternatively the SmPC can be accessed via the EMC website.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.

Adverse events should also be reported to Ferring Pharmaceuticals Ltd.

Tel: 0844 931 0050, Email: medical@ferring.com

Are you a Health Care Professional?

The following information is intended for UK Healthcare Professionals (HCPs). It contains information about prescribing, plus relevant patient information.

UY/2407/2017/UK September 2017