• 제목/요약/키워드: Enuresis frequency

검색결과 15건 처리시간 0.019초

야뇨의 병력청취 연구 (History taking in enuretic children)

  • 장규태;김장현;오주영
    • 대한한방소아과학회지
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    • 제18권2호
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    • pp.77-91
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    • 2004
  • Objectives : In evaluating a child with enuresis, an organized approach to the history leads to a working diagnosis and an appropriate treatment plan. but, there's no study about history taking in enuretic children. This article was undertaken to evaluate the enuretic child exactly and to study nocturnal enuresis systematically. Methods : It was conducted a computerized literature search in following database: Medline (via Pubmed), NDSL, EBSCO. Korean articles via oriental pediatric association homepage, KISS. Key words to search were 'nocturnal enuresis', 'bedwetting', 'enuresis', 'incontinence', 'management', 'evaluation', 'assessment', 'questionnaire', 'guideline', 'voiding dysfunction'. Results : Questions are grouped in eight categories: primary history(sex, age, height, weight), family history, enuresis history(primary/secondary, frequency, time of enuresis, nocturia), voiding history(average number, frequency, pattern, volume, posture, daytime enuresis), medical history, constipation/encopresis, sleep(OSA). Conclusion : A careful, complete history taking will help to plan treatment properly and to study.

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Enuresis as a Presenting Symptom of Graves' Disease: A Case Report

  • Hwang, Inseong;Park, Eujin;Lee, Hye Jin
    • Childhood Kidney Diseases
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    • 제25권1호
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    • pp.40-43
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    • 2021
  • Enuresis is intermittent urinary incontinence during sleep at night in children aged 5 years or older. The main pathophysiology of enuresis involves nocturnal polyuria, abnormal sleep arousal, and low functional bladder capacity. In rare cases, enuresis is an early symptom of endocrine disorders such as diabetes or thyroid disorders. Herein, we report a case of a 12-year-old girl with enuresis as a rare initial presentation of Graves' disease. She complained of nocturnal enuresis from a month before visiting our clinic. She also complained of urinary frequency, headache, and weight loss. On physical examination, she had tachycardia, intention tremors, and a diffuse goiter on her anterior neck with bruit on auscultation. Her thyroid function test results revealed hyperthyroidism, and Graves' disease was diagnosed as the thyroid stimulating hormone receptor autoantibody was positive. After treatment for Graves' disease with methimazole, symptoms of enuresis resolved within 2 weeks as she became clinically and biochemically euthyroid. In children with secondary enuresis, Graves' disease should be considered as a differential diagnosis, and signs of hyperthyroidism should be checked for carefully.

Effectiveness of Intra-anal Biofeedback and Electrical Stimulation in the Treatment of Children With Refractory Monosymptomatic Nocturnal Enuresis: A Comparative Randomized Controlled Trial

  • Abd El-Moghny, Seham Mohammed;El-Din, Manal Salah;El Shemy, Samah Attia
    • International Neurourology Journal
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    • 제22권4호
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    • pp.295-304
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    • 2018
  • Purpose: To compare the effects of intra-anal biofeedback (BF) and intra-anal electrical stimulation (ES) on pelvic floor muscles (PFMs) activity, nocturnal bladder capacity, and frequency of wet night episodes in children with refractory primary monosymptomatic nocturnal enuresis (PMNE). Methods: Ninety children of both sexes aged 8-12 years with refractory PMNE participated in this study. They were randomly assigned to 3 groups of equal number: control group (CON) that underwent behavioral therapy and PFM training, and 2 study groups (BF and ES) that underwent the same program in addition to intra-anal BF training and intra-anal ES, respectively. PFMs activity was assessed using electromyography, nocturnal bladder capacity was evaluated by measuring the first morning voided volume, and a nocturnal enuresis diary was used for documenting wet night episodes before treatment and after 3 months of treatment. Results: After training, all groups showed statistically significant improvements in all measured outcomes compared to their pretreatment findings. The ES group showed significantly greater improvements in all measured outcomes than the CON and BF groups. Conclusions: Both intra-anal BF training and ES combined with behavioral therapy and PFMs training were effective in the treatment of PMNE, with intra-anal ES being superior to BF training.

유뇨(遺尿)와 빈뇨(頻尿)를 동반한 과민성 방광증후군에 대한 동의보감(東醫寶鑑) 가감지황탕(加減地黃湯)을 이용한 치험 1례 (A Case Report : A Clinical Study on the Case of Irritable Bladder Syndrome with Enuresis and Frequent Urination Treated with Gagamzihwang-tang)

  • 최진용;서재호
    • 대한한의진단학회지
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    • 제14권1호
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    • pp.96-100
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    • 2010
  • Objective : The purpose of this case series was to investigate the effectiveness of GagamZihwang-tang for enuresis and frequent urination. Method : We prescribed GagamZihwang-tang and provided acupuncture therapy weekly. Results of before and after therapy were evaluated and scored twice a month. Results and conclusion : The study showed decrease of urination frequency from 17th-20th a day to 6th a day.

한방병원 야뇨 환아의 후향적 연구 (A follow-up study of enuretic children)

  • 장규태;김장현;오주영
    • 대한한방소아과학회지
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    • 제18권1호
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    • pp.179-191
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    • 2004
  • Objective: The aim of this study was to investigate enuretic children attending oriental hospital and classify subtypes and evaluate possible factors that enhance or hamper of continence. Methods: Children attending kyeongju dongguk oriental hospital pediatrics between January 2000 and December 2003 with chief complaint of nocturnal enuresis were enrolled. The data of present symptoms and improvement progress was collected via telephone interviews with their parents. Results: The total number of children was 61. 32 of them were male and 29 female. Sex ratio was 1.1:1. Patient under 6 years of age was 68.8%. Using acupuncture, acupressure or chimsband with herb medicine, treatment frequency was increased. Patients with nocturnal enuresis(NE) was 48, and primary nocturnal enuresis(PNE) 39, secondary (SNE) 9. 13 was impossible to diagnose. The ratio of male to female was 1:1.09. PNE was 4 times as many as SNE. Male was predominent in PNE, and female in SNE. In the progress of PNE, male and female were similiar. but SNE, male was all cured, female remained 50%. And elapsed time of male to improve was longer than that of female. In the progress of improvement, many parents mentioned that their child was improved spontaneously regardless of subtype. Conclusion: We consider age, sex distinction, subtype, bladder symptoms, frequency, time of progress as influencing factor of prognosis, but failed to verify significance. To develop guideline of NE and find influencing factor of prognosis, more prospective study through taking history carefully and using questionnaire is needed.

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일차성 야뇨증의 개관 (Primary Nocturnal Enuresis: An Overview)

  • 손동호
    • 수면정신생리
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    • 제2권1호
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    • pp.23-30
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    • 1995
  • 유뇨증은 발병기전이 단일한 원인으로 설명되기 어려운 임상적으로 복합적인 질병이다. 유전적 요인, 신경근육계 및 비뇨기계의 미성숙, 심리사회적 요인이나 대소변 가리기 훈련의 이상, 그리고 생물학적 요인 등 여러 가지 원인론들이 있으나 아직 확실한 것은 없다. 그러나 최근 신경생리학적 연구와 신경 내분비학적 연구들의 결과, 야뇨증과 수면주기와의 관련성이나 야간의 항이뇨호르몬 (antidiuretic hormone) 분비 저하와의 관련성 등 보고되어 야뇨증의 치료에 있어 새로운 접근을 가능하게 하고 있다. Vasopressin 이 우수한 치료율, 안전성, 적은 부작용 등으로 새로운 치료약물로서 시도되고 있으나 재발율이 높아, imipramine또는 vasopressin의 투여와 Bell-alarm행동요법을 병행하여 치료하는 것이 바람직하다.

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중극(中極) 관원(關元) 혈입(穴位)를 이용한 전침 치료 야뇨 환아 3례 (Three cases report about enuritic children treated with electro-acupuncture on Zhongji(CV3), Guanyuan(CV4))

  • 장규태;김장현;오주영
    • 대한한방소아과학회지
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    • 제19권1호
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    • pp.103-115
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    • 2005
  • Objectives : Nocturnal enuresis is common disorder in children and has important negative effects on the self-image and performance of children. Thus Successful treatment needed to increase self-esteem. Many studies of this symptoms were reported. But electro-acupuncture treatment not reported in Korea. Methods : We treated three cases enuretic children with different types. Their diagnosis were non-monosymptomatic primary, monosymptomatic primary, monosymptomatic secondary nocturnal enuresis. We used electro-acupuncture on Zhongji(CV3), Guanyuan(CV4) for 20 min. To investigate relapse. at least for 4 months after the end of the therapy we followed-up by telephone. Results : After treatment, diurnal urinary symptoms, such as increased frequency of urination, urgency, incontinence were dramatically improved. And the number of wet night decreased with nocturia and delayed wetting time. Compared to pre-treatment, findings, the number of wet nights decreased 80% or more. Conclusion : All of them tolerated electro-acupuncture well and kept reduction at least for 4 months follow-up. Further study is needed with more cases.

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일차성 단일증상성 야뇨증 환아에서 소변내로의 요칼슘배설에 대한 연구 (Urinary Calcium Excretion in Children with Primary Monosymptomatic Nocturnal Enuresis)

  • 정우영;조민현;박용훈;대한 소아배뇨장애야뇨증학회
    • Childhood Kidney Diseases
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    • 제15권2호
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    • pp.146-153
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    • 2011
  • 목적 : 야간다뇨증과 요실금을 가진 아동에서 고칼슘뇨증이 원인적 요인의 하나로 관여할 수 있다는 보고가 있으며, 일부 연구자들은 야뇨증을 가진 아동들을 진단함에 있어서 소변내로의 칼슘배설의 정도를 측정할 것을 권유하였다. 그러나 다른 연구자들은 야뇨증과 소변내로의 칼슘배설 사이에 의미있는 연관성을 입증하지 못했다. 이에 저자들은 일차성 단일증상성 야뇨증을 가진 환아들을 대상으로 소변내로의 칼슘 배설을 측정하여 야뇨증과의 관련성을 조사하였다. 방법:야뇨증으로 처음 진단 받은 5세 이상의 환자 36명을 대상으로 하였다. 혈장 칼슘농도를 측정하였으며, 단회뇨를 이용한 소변검사를 통해서 소변 삼투압, Na, 요소 및 Ca/Cr 농도비를 동시에 측정하였다. 24시간 소변의 채집은 오전 8시부터-오후 8시, 오후 8시부터-다음날 오전 8시로 두 번에 나누어 채집하였으며 각각의 소변 20-40 mL를 이용하여 삼투압과 Ca/Cr농도 비를 산출하였다. 고칼슘뇨증의 정의는 야뇨증 진단 당시에 주간(오전 8시-오후 8시)과 야간(오후 8시-오전 8시)으로 나누어 채집한 단회성 소변검사상에서 칼슘/크레아티닌 비가>0.2 이상이면서 24시간뇨 검사상 칼슘의 배설량이 ${\geq}4mg/kg$ 이상인 경우로 정의하였다. 결과: 36명의 환자 중에서 고칼슘뇨증에 해당하는 경우는 6명으로 16.7%의 빈도를 보였다. 고칼슘 뇨군에서의 단회뇨를 이용한 칼슘/크레아티닌 비는 주간뇨 검사에서는 $0.23{\pm}0.10$, 야간뇨 검사에서는 $0.33{\pm}0.10$로 야간뇨 검사에서 높았으나, 통계적인 유의성은 없었다. 24시간뇨 검사상의 평균 칼슘 배설량은 체중 (kg)당 8.95 mg이었다. 혈청 칼슘 농도와 주간/야간 소변량의 비도 고칼슘뇨군과 정상 칼슘군 사이에서 차이가 없었다. 또한 소변의 osmolality, Na 농도, 요소 농도 등도 양군사이에 유의한 차이가 없었다. 또한 주간이나 야간에 채집된 뇨에서 각각의 해당 기간 동안의 소변량과 칼슘/크레아티닌 비 그리고 칼슘/크레아티닌 비와 요중 Na농도, 요소농도, osmolality 간에는 유의한 상관관계는 없었다. 결론 : 야뇨증 환자의 일부에서 관찰되는 고칼슘 뇨증이 야간 다뇨에 의한 일차성 단일증상성 야뇨증의 직접적인 원인이 아니라고 생각한다.

First-morning urine osmolality changes in children with nocturnal enuresis at the end of treatment

  • Yun Ha Lee;Jae Min Chung;Sang Don Lee
    • Childhood Kidney Diseases
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    • 제28권1호
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    • pp.27-34
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    • 2024
  • Purpose: The ability to concentrate urine becomes an important index in determining nocturnal enuresis (NE) treatment. The aim of our study was to investigate first-morning urine osmolality (Uosm) changes at the end of treatment compared to before treatment in children with NE. Methods: A total of 71 children with NE were divided into two groups according to the level of first-morning Uosm before treatment: high group (≥800 mOsm/kg) and low group (<800 mOsm/kg). Baseline parameters were obtained from uroflowmetry, frequency volume charts for at least 2 days, and a questionnaire for lower urinary tract symptoms. All patients were basically treated with standard urotherapy and medication. The first-morning Uosm was measured twice, before treatment and at the end of treatment. Results: The response rate was higher in the low group after 3 months of treatment than in the high group (P=0.041). However, there was no difference between the two groups at the end of the treatment. In the high group, the first-morning Uosm at the end of treatment did not show a significant change compared to before treatment. In contrast, the first-morning Uosm increased in the low group at the end of treatment (P<0.001). However, it was still lower than that of the high group (P=0.007). Conclusions: The ability to concentrate nocturnal urine improved at the end of treatment compared to before treatment in the low Uosm NE children. In addition, NE improved faster in the low Uosm group before treatment than in the high group.

야뇨증 치료반응 예측에 관계하는 평가지표 (Clinical Parameters Predicting Responsiveness to Treatment in Enuresis Patients)

  • 이강균;이현정;임윤주;권덕근;김은진;배기수
    • Childhood Kidney Diseases
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    • 제11권2호
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    • pp.272-279
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    • 2007
  • 목 적 : 야뇨증 환자를 진료할 때 병인을 밝히고자 시행하는 문진, 야뇨기록, 배뇨기록, 각종 체액 화학검사, 영상검사 및 초기 평가기간 동안의 행동치료요법의 효과 등의 요소가 환자의 치료반응에 미치는 영향을 밝히고자 하였다. 방 법 : 2003년 1월부터 2007년 5월까지 야뇨증으로 아주대병원 소아과를 방문한 환아 159명을 대상으로 이들의 나이, 성별, 체중, 키, 최소배뇨용적, 최대배뇨용적, 배뇨횟수, 취침전후 요비중 변화 등을 측정하였으며, 치료 전 평가기간 2주째, 치료개시 후 2개월 시점의 야뇨증 호전 빈도를 측정하였다. 치료효과는 야뇨횟수가 90% 이상 감소될 경우를 완전반응, 50% 이상 90% 미만 감소된 경우를 부분반응, 50% 미만으로 감소된 경우를 무반응으로 구분하였다 또한 치료개시 이전 2주간의 평가기간 동안 야뇨증 횟수가 줄어든 환자들을 초기반응군 이라 칭하고, 그렇지 않은 초기불응군과 비교분석을 실시하였다. 결 과: 대상 환아는 총 159명이었으며 남자 74명(46.5%), 여자 85(53.5%)이었다. 연령분포는 5-6세 96명, 7-8세 38명, 9-14세 25명이었다. 일차성 야뇨증이 132명(83%)이었으며, 이차성이 27명(17%)이었다. 최소배뇨용적은 $40.9{\pm}31.0 mL$, 최대배뇨용적은 $156.7{\pm}69.2 mL$이었으며, 최대방광용적의 비는 $0.59{\pm}0.21$, 평균배뇨횟수는 하루 $6.7{\pm}2.2$회였다. 취침 전 소변의 비중을 취침 후와 비교하였을 때, 아침 소변의 비중이 감소된 요희석군은 59명(40.4%), 비중이 증가된 요농축군은 87명(59.5%)이었다. 2개월째 치료효과를 분석하였을 때, 요희석군은 무반응 7명(5.8%), 부분반응 23명(22.3%), 완전반응 9명(8.7%)으로 요농축군의 무반응 9명(8.7%), 부분반응 41명(39.8%), 완전반응 14명(13.6%)에 비하여 치료효과가 낮은 경향을 보였으나 통계적으로 유의하지는 않았다(P>0.05). 35명의 경우, 치료 2개월째 무반응 2명(5.7%), 부분반응 19명(54.3%), 완전반응 14명(40.0%)으로, 초기불응군 74명의 무반응 18명(24.3%), 부분반응 46명(62.2%), 완전반응 10명(13.5%)에 비해 치료효과가 높았다(P<0.05). 결 론 : 야뇨증환아에서 병원방문 이후 행동요법만으로 야뇨횟수에 호전을 보이는 초기반응군 경우 2개월째 투약반응이 유의하게 좋았다. 이로써 야뇨증의 치료초기 행동요법에 대한 반응정도는 치료효과를 예측하는 지표로서 활용될 수 있다고 판단된다.

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