The South African guidelines on Enuresis—2017

  • Ahmed Adam
  • Frederik Claassen
  • Ashraf Coovadia
  • Tim de Maayer
  • Margaret Fockema
  • Joy Fredericks
  • Errol Gottlich
  • Lizelle Grindell
  • Mohamed Haffejee
  • John Lazarus
  • Cecil Levy
  • Kgomotso Mathabe
  • Mignon McCulloch
  • Glenda Moonsamy
  • Evelyn Moshokoa
  • Shingai Mutambirwa
  • Haroun Patel
  • André van der Merwe
  • Izak Van Heerden
  • Frans Van Vijk
  • Aniruddh Deshpande
  • Grahame Smith
  • Piet Hoebeke
Keywords: Enuresis, Nocturnal Enuresis, South African, Therapeutic options, Mobile Phone Applications(Apps), Treatment guideline, Expert consensus

Abstract

Introduction: Enuresis (or Nocturnal Enuresis) is defined as discreet episodes of urinary incontinence duringsleep in children over 5 years of age in the absence of congenital or acquired neurological disorders.
Recommendations: Suggestions and recommendations are made on the various therapeutic options availablewithin a South African context. These therapeutic options include; behavioural modification, pharmaceuticaltherapy [Desmospressin (DDAVP), Anticholinergic (ACh) Agents, Mirabegron (3-adrenoreceptor ago-nists), and Tricyclic Antidepressants (TCA)], alternative treatments, complementary therapies, urotherapy,alarm therapy, psychological therapy and biofeedback. The role of the Bladder Diary, additional investiga-tions and Mobile Phone Applications (Apps) in enuresis is also explored. Standardised definitions are alsooutlined within this document.
Conclusion: An independent, unbiased, national evaluation and treatment guideline based on the patho-physiological subcategory is proposed using an updated, evidence based approach. This Guideline hasreceived endorsement from the South African Urological Association, Enuresis Academy of South Africaand further input from international experts within the field.

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eISSN: 1110-5704