Anticholinergic drugs, such as oxybutynin Ditropan or hyosyamine Levsinex , reduce or stop bladder contractions and increase bladder capacity. Anticholinergics alone are usually not helpful fo rchildren with isolated bed-wetting without any daytime voiding problems. This is often true for a child who has reduced functional bladder capacity. The reason behind this approach is that the DDAVP reduces night time urine output while the anticholinergic increases nighttime bladder colume.
Together, these drugs may prevent bed-wetting by keeping the bladder from becoming full during the night. For children older than 6 years, the dose of oxybutynin Ditropan XL is given once a day to children with daytime wetting symptoms. Another anticholinergic, hyoscamine, is also available in a long acting time capsule. The usual dosage is one hyosyamine twice daily.
For children with isolated bed-wetting, only the bedtime dose of oxybutynin or hyosyamine is required. Common side effects are dry mouth and facial flushing. Occasionally, flushing may occur when the child is exposed to hot weather.
An overdoes may result in blurring of vision and hallucinations. Fewer side effects have been reported with a newer anticholinergic, tolterodine Detrol , which is more specific for its action on the bladder. However, this drug is not yet approved for use in children under twelve years. Drug therapy of bedwetting is best thought of as a treatment, not a cure. Therefore, most children require long-term treatment to prevent a return of bed-wetting. In addition, desmopressin increases chemicals in the blood called factor VIII and von Willebrand factor VWF , which are important to stop bleeding and develop clots.
This explains its other roles beyond treating bedwetting. Desmopressin should not be used to treat bedwetting in children who are younger than 6 years old. In addition, the medication should not be used during periods of illness that might affect fluid intake or the balance of electrolytes such as in diarrhea or vomiting.
In addition, individuals with kidney problems, a history of low sodium called hyponatremia , or with von Willibrand disease type IIB should not use desmopressin. There are several other conditions in which desmopressin should be used only with caution, including coronary artery disease, high blood pressure hypertension , fluid or electrolyte imbalance, polydipsia excessive drinking , cystic fibrosis, clotting thrombosis risk, and in elderly patients.
Desmopressin has the potential to interact with many other drugs, so current medications should be carefully reviewed by your healthcare provider before you start to use it. There are a handful of potential side effects with the use of desmopressin. Although an individual would not be expected to experience most side effects—and may indeed not have any of them—some that may commonly occur with desmopressin include:.
With the use of any drug, including desmopressin, there is a risk of serious side effects. These occur more rarely, but some that may occur with the use of desmopressin include:. As noted above, certain people should use desmopressin with caution or not at all. As the medication works in the kidneys, it is important to establish normal kidney function by measuring the creatinine in your blood prior to starting the medication.
Once the disorder has been adequately treated, the medication needs to be slowly tapered off and should not be stopped abruptly. If your child experiences any difficulties with the use of desmopressin, you should be in close contact with your primary healthcare provider. Tossing and turning night over night can have a big impact on your quality of life. Also, do not give desmopressin to a child who has diarrhoea or is being sick vomiting until the illness has cleared.
Children with diarrhoea and vomiting should be given plenty of fluids. If you think you have had a side-effect to one of your medicines you can report this on the Yellow Card Scheme. You can do this online at www.
The Yellow Card Scheme is used to make pharmacists, doctors and nurses aware of any new side-effects that medicines or any other healthcare products may have caused. If you wish to report a side-effect, you will need to provide basic information about:. Cochrane Database Syst Rev. Eur J Pediatr. Epub Feb Hello, I'm 31 years old male. I'm posting here because maybe i can find answers. Around a year ago, I suddenly while sitting infront of the pc started to feel pain in the left testicle.
I remember Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
In this series. In this article What is desmopressin? How does desmopressin work? How effective is desmopressin? What are the advantages of desmopressin? What are the disadvantages of desmopressin? When and how is desmopressin used? Are there any side-effects with desmopressin? Jensen IN, Kristensen G. Alarm treatment: analyses of response and relapse. Friman PC. Nocturnal enuresis in the child. Principles and practice of sleep medicine in the child.
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Sign Up Now. Next: Osteoporosis in Men. Apr 1, Issue. Nocturnal Enuresis. TABLE 1 Classification Schemes for Enuresis According to time of day Nocturnal enuresis: passing of urine while asleep Diurnal enuresis or incontinence: leakage of urine during the day According to presence of other symptoms Monosymptomatic or uncomplicated nocturnal enuresis: normal voiding occurring at night in bed in the absence of other symptoms referable to the urogenital or gastrointestinal tract Polysymptomatic or complicated nocturnal enuresis: bedwetting associated with daytime symptoms such as urgency, frequency, chronic constipation, or encopresis According to previous periods of dryness Primary enuresis: bed-wetting in a child who has never been dry Secondary enuresis: bed-wetting in a child who has had at least six months of nighttime dryness.
Does your child have a history of problems with his or her nervous system? Did you or your child's other parent wet the bed as a child? Positive answer suggests complicated nocturnal enuresis Does your child appear to have pain with urination? Urinary tract infection How often does your child have bowel movements? Infrequent stools: constipation Are bowel movements ever hard to pass?
Constipation Does your child ever soil his or her pants? Encopresis To distinguish possible functional bladder disorder from nocturnal polyuria: How many times a day does your child void? More than seven times a day: functional bladder disorder Does your child have to run to the bathroom? Positive response: functional bladder disorder Does your child hold urine until the last minute? Positive response: functional bladder disorder How many nights a week does your child wet the bed?
Most nights: functional bladder disorder one or two nights: nocturnal polyuria Does your child ever wet more than once a night?
Positive response: functional bladder disorder Does your child seem to wet large or small volumes? Large volumes: nocturnal polyuria Small volumes: functional bladder disorder To determine how parents have handled bed-wetting: How have you handled the nighttime accident? Read the full article. Get immediate access, anytime, anywhere.
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Best Value! To see the full article, log in or purchase access. The Author show all author info C. More in Pubmed Citation Related Articles. Email Alerts Don't miss a single issue. Sign up for the free AFP email table of contents. Navigate this Article. According to time of day. Nocturnal enuresis: passing of urine while asleep.
Diurnal enuresis or incontinence: leakage of urine during the day.
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