Management of Nocturnal Enuresis by Conditioned Response
Treatment of chronic nocturnal enuresis often poses a vexing problem, and even prolonged programs employing the conventional therapeutic methods are frequently fruitless. That this is a major problem, especially in pediatrics, is attested to by estimates of up to 16% incidence in the child population (1) and also by the profuse literature on the subject. Although the incidence is smaller in higher age brackets, enuresis presents the adult patient with a serious problem that often has a pronounced effect on his social adjustment. A few cases of enuresis, variously estimated at from 3 to 10% (2) of the total, arise from definite anatomic or physiological anomalies for which specific surgical or medical procedures are indicated. The majority of cases appear, however, in children who simply have never been able to respond to the stimulation of a full bladder by awakening. After the age of 3 or 3 1/2 years, when the average child becomes a deep sleeper, self-training becomes even more difficult.
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