Comparative evaluation of the efficacy of medical treatment programs of primary multi-symptom enuresis in children

The purpose of the study: To develop a complex program for the treatment of multi-symptom enuresis in children based on analysis of etiopathogenic factors leading to the formation of the disease. Material and methods: 107 patients aged 5 to 12 years with complaints of bedwetting with features of primary enuresis, occurring at least 3 times a month and lasting at least 3 consecutive months were enrolled in the study. Exclusion criteria were the presence of malformations of the urinary system, requiring surgical correction; acute infection of the urinary system; chronic kidney disease; acute stage of chronic somatic comorbidities; endocrine diseases; organic pathology of the central and peripheral nervous system; mental disorders. The study used the following methods: clinical signs and history, laboratory tests, urodynamic examination, instrumental radiological and neurophysiological methods, examination of the autonomic nervous system, assessment of quality of life (questionnaire Pediatric Quality of Life Inventory - PedsQL TM4.0). Results: The most important etiopathogenetical factors of primary multi-symptom enuresis (PME) in children were identified and their role in the development of the disease was established. The role of the autonomic nervous system dysfunction in the development of PES in children depending on the functioning of the bladder was proven. Affected aspects of quality of life were determined and the necessity of early treatment of children with PES was substantiated. Given the findings of the study, combination therapy was proposed and substantiated. Its efficacy was evaluated and compared with monotherapy. The study results showed a significant positive cumulative effect (82.5%) of the combination therapy of multi-symptom enuresis (p<0.05).

primary multi-symptom enuresis, etiopathogenic factors, autonomic nervous system, the combination therapy, quality of life