Night-wetting children will be better treated in Poland, thanks to the new guidelines on diagnosis and treatment of this ailment. An important step is also the decision of the minister of health to reimburse the drug needed for some of the wetting children, experts estimate.
Doctors and parents of young patients spoke about it on Thursday at a press conference organized in the capital by the Uronef – Our Children Association.
“We finally have the tools to correctly diagnose and treat night-wetting babies in primary care. Parents will not have to look for specialists all over the country, of whom there are very few, but they will be able to receive appropriate help from their GP or pediatrician, ”said Uronef spokesman Dorota Różycka.
According to the president of the association, Beata Remańska, it will be possible thanks to the guidelines on the diagnosis and treatment of night-wetting children, developed at the initiative of the Ministry of Health, and the introduction of a drug called desmopressin on the reimbursement list from September 1, 2012.
As noted by Dr. Michał Maternik from the Department of Kidney Diseases and Hypertension of Children and Adolescents of the Medical University of Gdańsk, co-author of the guidelines, they show, step by step, to primary care physicians and paediatricians how to diagnose and treat children wetting at night. On the other hand, they are to help identify a group of patients at the primary care level (POZ) in whom enuresis may be a symptom of a more serious urinary system disease and those who should be referred to a specialist – a nephrologist or pediatric urologist.
The head of the Mother and Child Department at the Ministry of Health, Krystyna Czaplicka-Trojanowska, who was present at the meeting, emphasized that the ministry distributed copies of the new guidelines to all primary health care facilities through local sanitary and epidemiological stations. In addition, the Ministry of Health published a publication on its website, and with the help of national consultants from particular fields of paediatrics, it plans to provide these materials also to specialist clinics. The Polish Pediatric Society has also undertaken to distribute them.
Czaplicka-Trojanowska reminded that desmopressin will be reimbursed (with a 30% fee) to patients over 6 years of age, provided that the previous three-month procedure consisting in supporting and motivating a child wetting the night was unsuccessful. Thanks to this, parents will pay PLN 31,64 for one package of a lower dose of the drug, instead of PLN 94,85, and for a larger dose, PLN 54,18 instead of PLN 180,68.
As explained in an interview with PAP, Prof. Małgorzata Baka-Ostrowska, national consultant in the field of pediatric urology, desmopressin is not intended for all children who wet at night. “There are many treatments for this disorder, depending on its causes. However, it is an indispensable drug in the treatment of this group of children in whom bedwetting is caused by a deficiency of vasopressin at night “- said the specialist who led the group of experts at the Ministry of Health responsible for the creation of the document entitled” Diagnostic and therapeutic guidelines for bedwetting baby “.
She added that currently this drug cannot be replaced with anything, so it is very positive that it has been entered on the reimbursement list.
Dr. Grzegorz Paruszkiewicz, a pediatric surgeon, who was present at the Thursday conference, recalled that the deficiency of vasopressin – a hormone that thickens the urine at night – is one of the two main causes of the so-called monosymptomatic bedwetting. This name means that it is not associated with any defect or disease of the urinary or nervous system, but with the fact that during the development period, the child has not developed complete control over the function of the urinary bladder.
At 300 children who wake up every morning in Poland fearing that the bed will be wet again, 85 percent he just has monosymptomatic wetting. The second major cause of this type of enuresis is insufficient functional bladder capacity.
Unfortunately, there is still a misconception among parents and many doctors that bedwetting is a consequence of emotional disorders in a child, emphasized Paruszkiewicz. That is why they often direct their first steps to a psychologist. Meanwhile, persistent bedwetting causes emotional disturbances in these patients. “These children have worse self-esteem, a sense of isolation among their peers, and their problem also becomes a source of conflicts in the family. Over time, parents begin to show a rejecting attitude towards them, because they think that the child is simply lazy “- the expert mentioned.
According to the data he presented, only 15% of soaking grows spontaneously (without therapy) every year. kids. (PAP)
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