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Enurese (nattenurese)

Sist revidert:
Sist revidert av:
Definisjon:
Ufrivillig vannlatning under søvn uten at det foreligger skade på nervesystem eller urinveier. Primær eller sekundær. Skyldes umoden regulering av antidiuretisk hormon, problemer med å våkne eller lite blærevolum. Arv disponerer.
Forekomst:
Vanligst hos gutter. 8% av 4,5 år gamle barn og 1,5% av 9,5 år gamle barn har ≥ 2 våte netter per uke
Symptomer:
Det kan foreligge symptomer forenlig med søvnproblemer på grunn av regelmessig oppvåkning på natt
Funn:
Kliniske funn skal være normale, obs obstipasjon
Diagnostikk:
Ved tvil om diagnosen kan man utføre urinundersøkelser og måling av blærevolum
Behandling:
Består av enkel intervensjon med registrering av tørre/ våte netter, alarmmatte og eventuelt medikamenter som desmopressin 
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  2. Lie A, Gjerstad AC, Fossum V, et al. Vannlatingsforstyrrelser hos barn – en praktisk tilnærming. Tidsskr Nor Laegeforen. 2020;140(2):10.4045/tidsskr.18.0565. Published 2020 Jan 29. doi:10.4045/tidsskr.18.0565 DOI  
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  5. Butoler R, Heron J. An exploration of children's views of bed-wetting at nine years. Child Care Health Dev 2008; 34: 65-70. PubMed  
  6. Nevéus T. Nocturnal enuresis-theoretic background and practical guidelines. Pediatr Nephrol. 2011;26(8):1207–1214.
  7. Dossche L, Walle JV, Van Herzeele C. The pathophysiology of monosymptomatic nocturnal enuresis with special emphasis on the circadian rhythm of renal physiology. Eur J Pediatr 2016; 175: 747. pmid:27138767 PubMed  
  8. Nevéus T. Pathogenesis of enuresis: Towards a new understanding. Int J Urol 2017; 24: 174. pmid:28208214 PubMed  
  9. Vande Walle J, Rittig S, Bauer S, Eggert P, Marschall-Kehrel D, Tekgul S; American Academy of Pediatrics; European Society for Paediatric Urology; European Society for Paediatric Nephrology; International Children's Continence Society. Practical consensus guidelines for the management of enuresis. Eur J Pediatr. 2012;171(6):971–983.
  10. Abrams P, Andersson KE, Birder L, et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213–240.
  11. Nunes VD, O'Flynn N, Evans J, et al. Management of bedwetting in children and young people: summary of NICE guidance. BMJ 2010; 341: c5399. BMJ (DOI)  
  12. Caldwell PHY, Nankivell G, Sureshkumar P. Simple behavioural interventions for nocturnal enuresis in children. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD003637. DOI: 10.1002/14651858.CD003637.pub3. DOI  
  13. Caldwell PHY, Codarini M, Stewart F, Hahn D, Sureshkumar P. Alarm interventions for nocturnal enuresis in children. Cochrane Database of Systematic Reviews 2020, Issue 5. The Cochrane Library  
  14. Kwak KW, Lee YS, Park KH, Baek M. Efficacy of desmopressin and enuresis alarm as first and second line treatment for primary monosymptomatic nocturnal enuresis: Prospective randomized crossover study. J Urology 2010; 184: 2521-26. PubMed  
  15. Caldwell PHY, Sureshkumar P, Wong WCF. Tricyclic and related drugs for nocturnal enuresis in children. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD002117. DOI: 10.1002/14651858.CD002117.pub2 DOI  
  16. National Institute for Health and Care Excellence. Nocturnal enuresis: the management of bedwetting in children and young people. NICE clinical guideline 111. 2010. Accessed August 13, 2014.
  17. Deshpande AV, Caldwell PHY, Sureshkumar P. Drugs for nocturnal enuresis in children (other than desmopressin and tricyclics). Cochrane Database of Systematic Reviews 2012, Issue 12. Art. No.: CD002238. DOI: 10.1002/14651858.CD002238.pub2. DOI  
  18. Glazener CMA, Evans JHC. Desmopressin for nocturnal enuresis in children. Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD002112. DOI: 10.1002/14651858.CD002112 DOI  
  19. Tekgül S, Riedmiller H, Dogan HS, et al. Guidelines on paediatric urology. European Association of Urology, European Society for Paediatric Urology, 2012. Accessed March 11, 2012.[url]http://www.uroweb.org/gls/pdf/21_Paediatric_Urology_LR%20[correctie%20Hoebeke].pdf[/url]
  20. Statens legemiddelverk: "Fraråder desmopressin nesespray og -dråper mot sengevæting". Første gang publisert: 10.05.2007
  21. Austin PF, Ferguson G, et al. Combination therapy with desmopressin and an anticholinergic medication for nonresponders to desmopressin for monosymptomatic nocturnal enuresis: A randomized, double-blind, placebo-controlled trial. Pediatrics 2008; 122: 1027-32. Pediatrics  
  22. Diseth TH, Vandvik IH. Hypnoterapi ved behandlingsrefraktær enuresis nocturna. Tidsskr Nor Lægeforen 2004; 124: 488-91. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Kurt Østhuus Krogh, spesialist i barnesykdommer, Norsk Helseinformatikk/ Barne-og ungdomsklinikken, St. Olavs Hospital
  • Arnfinn Seim, førsteamanuensis i allmennmedisin, Institutt for samfunnsmedisinske fag, Norges teknisk-naturvitenskapelige universitet, Trondheim
  • Stein E Høyer, overlege barneavdelingen, Regionsykehuset i Tromsø