Nocturnal Enuresis as a Specific Compensatory Syndrome

Alexander Zaler Golbin; Anastasiia Tsarenko

doi:doi:10.11648/j.ajcem.20170506.13

| Peer-Reviewed

Nocturnal Enuresis as a Specific Compensatory Syndrome

Alexander Zaler Golbin, Anastasiia Tsarenko

Published in American Journal of Clinical and Experimental Medicine (Volume 5, Issue 6)

Received: 22 August 2017 Accepted: 6 September 2017 Published: 9 October 2017

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

The pathophysiological nature of the monosymptomatic primary nocturnal enuresis (PNE) in children is still the unresolved problem. The most hypotheses of pathogenesis of nocturnal enuresis are limited within anatomical, biochemical and physiological regulation of the urinary control. Based on our own observations as well as the data reported in the literature, we have concluded that in addition to described biological causes of this disorder, we should focus on the common clinical and developmental features observed in the majority of cases of the monosymptomatic primary nocturnal enuresis that could be united as “enuretic syndrome”. In attempt to move “outside of the box” of the urinary control we have put forward a hypothesis that enuresis is a specific compensatory syndrome which is self-developed by the child’s organism to “offset” the deviated sleep–wake mechanisms. This concept is based on the general “control system theory” and offers the explanations of the majority of symptoms. From the compensatory “offset” concept the treatment of PNE should be focused not on the suppression of the act of enuresis but on the stabilization of circadian sleep-wake mechanisms. Further investigations are needed to evaluate the validity of this concept.

Published in	American Journal of Clinical and Experimental Medicine (Volume 5, Issue 6)
DOI	10.11648/j.ajcem.20170506.13
Page(s)	197-204
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Enuresis, Bedwetting, Adaptation Syndrome, Compensatory Model, Etiology of Enuresis

References

[1]	T. Nevéus, A. von Gontard, P. Hoebeke, K. Hjälmås, S. Bauer, W. Bower, T. M. Jørgensen, S. Rittig, J. V. Walle, C.-K. Yeung, and J. C. Djurhuus, “The Standardization of Terminology of Lower Urinary Tract Function in Children and Adolescents: Report from the Standardisation Committee of the International Children's Continence Society,” Int J Urol, vol. 176(1), pp. 314-324, 2006.
[2]	P. F. Austin, S. B. Bauer, W. Bower, J. Chase, I. Franco, P. Hoebeke, S. Rittig, J. V. Walle, A. von Gontard, A. Wright, S. S. Yang, and T. Nevéus, “The Standardization of Terminology of Lower Urinary Tract Function in Children and Adolescents: Update Report from the Standardization Committee of the International Childrens Continence Society,” Int J Urol, vol. 191(6), pp. 1863-1865, 2014.
[3]	G. Lehmkuhl, W. Berner, A. von Gontard, K. Mauer-Mucke, and J. Pluck, "Clinical behavioral problems in day- and night-wetting children," Pediatric Nephrology, vol. 13, pp. 662-667, 1999.
[4]	W. L. Robson, and A. K. Leung, “Secondary nocturnal enuresis,” Clinical Pediatrics vol. 39(7), pp. 379-85, 2000.
[5]	Etiology. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. (2003).
[6]	A. von Gontard, "Klassifikation der Enuresis/ Enkopresis im DSM-5," Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, vol. 42, pp. 109-113, 2014.
[7]	S. Akhtar, A Comprehensive Dictionary of Psychoanalysis. KARNAC BOOKS: 2009.
[8]	A. Malavazos, “N/A”, The Urologic and cutaneous review, vol. 39, pp. 322, 1935.
[9]	A. C. McGuinness, “The treatment of enuresis in childhood”, Medical Clinics of North America, vol. 19, pp. 287–294, 1935.
[10]	O. H. Mowrer, and W. M Mowrer, “N/A”, American Journal of Orthopsychiatry, vol. 8, pp. 436, 1938.
[11]	J. J. Michaels, and S. E. Goodman, “N/A,” Archives of Neurology & Psychiatry, vol. 40, pp. 699, 1938.
[12]	S. E. Gill, “N/A,” British Medical Journal, vol. 2, pp. 199, 1940.
[13]	G. Clark, “N/A,” The Urologic and cutaneous review, vol. 49, pp. 612, 1945.
[14]	I. N. Kugelmass, “N/A,” New York state journal of medicine, vol. 47, pp. 1369, 1947.
[15]	S. William, M. D. Walsh, “Dreams of the feeble-minded,” Medical Record, vol. 97, pp. 395-398, 1920.
[16]	J. V. Braithwaite, “N/A,” Practitioner, vol. 165, pp. 273, 1950.
[17]	K. Breitlander, “N/A,” Strahlentherapie, vol. 82, pp. 307, 1950.
[18]	B. Hallgren, Enuresis a Clinical and Genetic Study, Acta Psychiatrica et Neurologica Scandinavica Sup.: 1957.
[19]	M. D. Harari, “Nocturnal enuresis,” Journal of Paediatrics and Child Health, vol. 49 (4), pp. 264-271, 2012.
[20]	J. M. Macdonald, “The threat to kill,” American Journal of Psychiatry, vol. 120 (2), pp. 125-130, 1963.
[21]	R. J. Broughton, “Sleep Disorders: Disorders of Arousal?: Enuresis, somnambulism, and nightmares occur in confusional states of arousal, not in "dreaming sleep,"” Science, vol. 159 (3819), pp. 1070-1078, 1968.
[22]	I. Kolvin, R. C. MacKeith, and S. R. Meadow, Bladder Control and Enuresis (Ch. 20), Heinemann Medical: 1973.
[23]	I. Kolvin, R. C. MacKeith, and S. R. Meadow, Bladder Control and Enuresis (Ch. 12), Heinemann Medical: 1973.
[24]	V. N. Puri, “Urinary levels of antidiuretic hormone in nocturnal enuresis,” Indian Pediatrics, vol. 17(8), pp. 675-676, 1980.
[25]	N. Wolfish, R. Pivik, and K. Busby, “Elevated sleep arousal thresholds in enuretic boys: clinical implications,” Acta Paediatrica, vol. 86 (4), pp. 381-384, 1997.
[26]	A. Kawauchi, N. Imada, Y. Tanaka, M. Minami, H. Watanabe, and S. Shirakawa, "Changes in the structure of sleep spindles and delta waves on electroencephalography in patients with nocturnal enuresis," BJU International, vol. 81, pp. 72-75, 1998.
[27]	T. Nevéus, "Enuretic Sleep: A Polysomnographic Study," Scandinavian Journal of Urology and Nephrology, vol. 33, pp. 27-27, 1999.
[28]	N. Wolfish, "Sleep Arousal Function in Enuretic Males," Scand. J. Urol. Nephrol., vol. 33, pp. 24-26, 1999.
[29]	J. M. Hunsballe, "Increased Delta Component in Computerized Sleep Electroencephalographic Analysis Suggests Abnormally Deep Sleep in Primary Monosymptomatic Nocturnal Enuresis," Scandinavian Journal of Urology and Nephrology, vol. 34, pp. 294-302, 2000.
[30]	M. R. Dundaröz, M. Denli, M. Uzun, H. I. Aydin, S. U. Sarici, M. Yokuşoğlu, and S. Ulgen, “Analysis of heart rate variability in children with primary nocturnal enuresis,” International Urology and Nephrology, vol. 32(3), pp. 393-397, 2001.
[31]	G. Bader, T. Nevéus, S. Kruse, and U. Sillén, “Sleep of primary enuretic children and controls,” Sleep, vol. 25(5), pp. 579-583, 2002.
[32]	M. Unalacak, M. Aydin, B. Ermis, A. Ozeren, A. Sogut, F. Demirel, and I. Unluoglu, “Assessment of Cardiac Autonomic Regulation in Children with Monosymptomatic Nocturnal Enuresis by Analysis of Heart Rate Variability,” Tohoku University Medical Press, vol. 204, pp. 63-69, 2004.
[33]	C. K. Yeung, M. Diao, and B. Sreedhar, "Cortical Arousal in Children with Severe Enuresis," New England Journal of Medicine, vol. 358, pp. 2414-2415, 2008.
[34]	K. Dhondt, A. Raes, P. Hoebeke, E. V. Laecke, C. V. Herzeele, and J. V. Walle, "Abnormal Sleep Architecture and Refractory Nocturnal Enuresis," The Journal of Urology, vol. 182, pp. 1961-1966, 2009.
[35]	V. Cohen-Zrubavel, B. Kushnir, J. Kushnir, and A. Sadeh, “Sleep and Sleepiness in Children with Nocturnal Enuresis,” Sleep, vol. 34(2), pp. 191–194, 2011.
[36]	K. Dhondt, E. Baert, C. V. Herzeele, A. Raes, L.-A. Groen, P. Hoebeke, and J. V. Walle, "Sleep fragmentation and increased periodic limb movements are more common in children with nocturnal enuresis," Acta Paediatrica, vol. 103, pp. e268-e272, 2014.
[37]	Dhondt, K., Herzeele, C. V., Roels, K. Dhondt, C. V. Herzeele, S. P. Roels, A. Raes, L.-A. Groen, P. Hoebeke, and J. V. Walle, "Sleep fragmentation and periodic limb movements in children with monosymptomatic nocturnal enuresis and polyuria," Pediatr Nephrol, vol. 30, pp. 1157-1162, 2015.
[38]	A. Z. Golbin, The World of Children's Sleep, Michaelis Medical Publishing Corp: 1995.
[39]	A. Z. Golbin, H. Kravitz, G. Keith Louis, Sleep Psychiatry, Taylor & Francis CRC Press: 2004.
[40]	A. Z. Golbin, and D. A Golbin, Parasomnias Could Have Adaptive functions, World Association of Sleep Medicine (Germany), Poster 119, 2005.
[41]	J. C. Gilin, J. I. Rapoport, F. J. Mikkelsen, D. Langer, C. Vanskiver, and W. Mendelson, “EEG sleep patterns in enuretics: a further analysis and comparison with normal control,” Biol. Psychiatry, vol. 1982 (77), pp. 947-52, 1982.
[42]	I. Jönson Ring, A. Markström, F. Bazargani, and T. Nevéus, “Sleep disordered breathing in enuretic children and controls,” J Pediatr Urol, 2017.
[43]	T. Nevéus, “Pathogenesis of enuresis: Towards a new understanding,” International Journal of Urology, vol. 24(3), pp. 174-182, 2017.
[44]	A. Z. Golbin, A. Umantsev, “Adaptive chaos: mild disorder may help contain major disease,” Medical Hypotheses, vol. 66, pp. 182-187, 2006.
[45]	Avicenna (Abu Ali ibn Cina), “Canon of Medical Science”, UZSSE: Nauka, Book 3, v. 19: 338, 1986.

Cite This Article

Plain Text BibTeX RIS

APA Style

Alexander Zaler Golbin, Anastasiia Tsarenko. (2017). Nocturnal Enuresis as a Specific Compensatory Syndrome. American Journal of Clinical and Experimental Medicine, 5(6), 197-204. https://doi.org/10.11648/j.ajcem.20170506.13

Copy | Download

ACS Style

Alexander Zaler Golbin; Anastasiia Tsarenko. Nocturnal Enuresis as a Specific Compensatory Syndrome. Am. J. Clin. Exp. Med. 2017, 5(6), 197-204. doi: 10.11648/j.ajcem.20170506.13

Copy | Download

AMA Style

Alexander Zaler Golbin, Anastasiia Tsarenko. Nocturnal Enuresis as a Specific Compensatory Syndrome. Am J Clin Exp Med. 2017;5(6):197-204. doi: 10.11648/j.ajcem.20170506.13

Copy | Download

@article{10.11648/j.ajcem.20170506.13,
  author = {Alexander Zaler Golbin and Anastasiia Tsarenko},
  title = {Nocturnal Enuresis as a Specific Compensatory Syndrome},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {5},
  number = {6},
  pages = {197-204},
  doi = {10.11648/j.ajcem.20170506.13},
  url = {https://doi.org/10.11648/j.ajcem.20170506.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20170506.13},
  abstract = {The pathophysiological nature of the monosymptomatic primary nocturnal enuresis (PNE) in children is still the unresolved problem. The most hypotheses of pathogenesis of nocturnal enuresis are limited within anatomical, biochemical and physiological regulation of the urinary control. Based on our own observations as well as the data reported in the literature, we have concluded that in addition to described biological causes of this disorder, we should focus on the common clinical and developmental features observed in the majority of cases of the monosymptomatic primary nocturnal enuresis that could be united as “enuretic syndrome”. In attempt to move “outside of the box” of the urinary control we have put forward a hypothesis that enuresis is a specific compensatory syndrome which is self-developed by the child’s organism to “offset” the deviated sleep–wake mechanisms. This concept is based on the general “control system theory” and offers the explanations of the majority of symptoms. From the compensatory “offset” concept the treatment of PNE should be focused not on the suppression of the act of enuresis but on the stabilization of circadian sleep-wake mechanisms. Further investigations are needed to evaluate the validity of this concept.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Nocturnal Enuresis as a Specific Compensatory Syndrome
AU  - Alexander Zaler Golbin
AU  - Anastasiia Tsarenko
Y1  - 2017/10/09
PY  - 2017
N1  - https://doi.org/10.11648/j.ajcem.20170506.13
DO  - 10.11648/j.ajcem.20170506.13
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 197
EP  - 204
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20170506.13
AB  - The pathophysiological nature of the monosymptomatic primary nocturnal enuresis (PNE) in children is still the unresolved problem. The most hypotheses of pathogenesis of nocturnal enuresis are limited within anatomical, biochemical and physiological regulation of the urinary control. Based on our own observations as well as the data reported in the literature, we have concluded that in addition to described biological causes of this disorder, we should focus on the common clinical and developmental features observed in the majority of cases of the monosymptomatic primary nocturnal enuresis that could be united as “enuretic syndrome”. In attempt to move “outside of the box” of the urinary control we have put forward a hypothesis that enuresis is a specific compensatory syndrome which is self-developed by the child’s organism to “offset” the deviated sleep–wake mechanisms. This concept is based on the general “control system theory” and offers the explanations of the majority of symptoms. From the compensatory “offset” concept the treatment of PNE should be focused not on the suppression of the act of enuresis but on the stabilization of circadian sleep-wake mechanisms. Further investigations are needed to evaluate the validity of this concept.
VL  - 5
IS  - 6
ER  -

Copy | Download

Author Information

Alexander Zaler Golbin

Sleep and Behavior Medicine Institute, Chicago, USA
Anastasiia Tsarenko

Sleep and Behavior Medicine Institute, Chicago, USA

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Alexander Zaler Golbin, Anastasiia Tsarenko. (2017). Nocturnal Enuresis as a Specific Compensatory Syndrome. American Journal of Clinical and Experimental Medicine, 5(6), 197-204. https://doi.org/10.11648/j.ajcem.20170506.13

Copy | Download

ACS Style

Alexander Zaler Golbin; Anastasiia Tsarenko. Nocturnal Enuresis as a Specific Compensatory Syndrome. Am. J. Clin. Exp. Med. 2017, 5(6), 197-204. doi: 10.11648/j.ajcem.20170506.13

Copy | Download

AMA Style

Alexander Zaler Golbin, Anastasiia Tsarenko. Nocturnal Enuresis as a Specific Compensatory Syndrome. Am J Clin Exp Med. 2017;5(6):197-204. doi: 10.11648/j.ajcem.20170506.13

Copy | Download

@article{10.11648/j.ajcem.20170506.13,
  author = {Alexander Zaler Golbin and Anastasiia Tsarenko},
  title = {Nocturnal Enuresis as a Specific Compensatory Syndrome},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {5},
  number = {6},
  pages = {197-204},
  doi = {10.11648/j.ajcem.20170506.13},
  url = {https://doi.org/10.11648/j.ajcem.20170506.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20170506.13},
  abstract = {The pathophysiological nature of the monosymptomatic primary nocturnal enuresis (PNE) in children is still the unresolved problem. The most hypotheses of pathogenesis of nocturnal enuresis are limited within anatomical, biochemical and physiological regulation of the urinary control. Based on our own observations as well as the data reported in the literature, we have concluded that in addition to described biological causes of this disorder, we should focus on the common clinical and developmental features observed in the majority of cases of the monosymptomatic primary nocturnal enuresis that could be united as “enuretic syndrome”. In attempt to move “outside of the box” of the urinary control we have put forward a hypothesis that enuresis is a specific compensatory syndrome which is self-developed by the child’s organism to “offset” the deviated sleep–wake mechanisms. This concept is based on the general “control system theory” and offers the explanations of the majority of symptoms. From the compensatory “offset” concept the treatment of PNE should be focused not on the suppression of the act of enuresis but on the stabilization of circadian sleep-wake mechanisms. Further investigations are needed to evaluate the validity of this concept.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Nocturnal Enuresis as a Specific Compensatory Syndrome
AU  - Alexander Zaler Golbin
AU  - Anastasiia Tsarenko
Y1  - 2017/10/09
PY  - 2017
N1  - https://doi.org/10.11648/j.ajcem.20170506.13
DO  - 10.11648/j.ajcem.20170506.13
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 197
EP  - 204
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20170506.13
AB  - The pathophysiological nature of the monosymptomatic primary nocturnal enuresis (PNE) in children is still the unresolved problem. The most hypotheses of pathogenesis of nocturnal enuresis are limited within anatomical, biochemical and physiological regulation of the urinary control. Based on our own observations as well as the data reported in the literature, we have concluded that in addition to described biological causes of this disorder, we should focus on the common clinical and developmental features observed in the majority of cases of the monosymptomatic primary nocturnal enuresis that could be united as “enuretic syndrome”. In attempt to move “outside of the box” of the urinary control we have put forward a hypothesis that enuresis is a specific compensatory syndrome which is self-developed by the child’s organism to “offset” the deviated sleep–wake mechanisms. This concept is based on the general “control system theory” and offers the explanations of the majority of symptoms. From the compensatory “offset” concept the treatment of PNE should be focused not on the suppression of the act of enuresis but on the stabilization of circadian sleep-wake mechanisms. Further investigations are needed to evaluate the validity of this concept.
VL  - 5
IS  - 6
ER  -

Copy | Download