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Brain focused treatment

2 nd CNN. Brain focused treatment. Department of Urology, Kyoto Prefectural University of Medicine. Akihiro Kawauchi, M.D., Ph.D. Nocturnal enuresis ： Voiding during sleep. Causes: Sleep (including nocturnal polyuria), bladder or both. Brain focused treatment?.

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Brain focused treatment

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  1. 2nd CNN Brain focused treatment Department of Urology, Kyoto Prefectural University of Medicine Akihiro Kawauchi, M.D., Ph.D.

  2. Nocturnal enuresis：Voiding during sleep • Causes: Sleep (including nocturnal polyuria), bladder or both

  3. Brain focused treatment?

  4. The Health-related Quality of Life in patients and mothers of patients withnocturnal enuresis

  5. The health-related quality of life in enuretic children evaluated before and after treatment (Kid-kindle) P value** Before treatment vs. Healthy volunteers P value* Before vs. after treatment After treatment Before treatment Healthy volunteers Domain 0.36 16.9±2.6 0.08 Physical well-being 17.3±2.0 16.6±2.6 17.7±2.2 17.3±2.3 0.08 0.38 Emotional well-being 17.1±2.4 12.8±3.8 0.26 Self-esteem 12.5±4.1 0.46 13.2±3.8 0.02 14.7±3.4 15.7±2.8 15.7±2.9 Family 0.04 0.27 16.2±2.9 16.7±2.8 0.97 Friend 16.2±1.1 0.16 0.34 14.2±3.2 14.3±1.1 School 13.7±3.1 * paired-t test * * t test J Urol, in press

  6. The health-related quality of life in mothers of enuretic children evaluated before and after treatment (SF36) Beforetreatment P value** Before treatment vs. Healthy volunteers P value* Before vs. after treatment After treatment Healthy volunteers Domain 92.5±8.8 Physical functioning 91.9±9.1 91.7±10.5 0.58 0.89 91.2±15.5 Role physical 0.35 0.44 88.9±17.3 90.7±13.5 72.8±19.8 71.9±22.2 73.1±17.0 0.91 0.68 Body pain 0.69 67.2±16.2 65.3±16.0 0.71 66.2±17.1 General health 0.03 0.01 Vitality 60.1±10.1 66.1±16.6 64.8±17.9 0.86 89.5±16.3 89.1±15.8 88.4±17.2 0.66 Social functioning Role emotional 88.6 ±17.7 89.9 ±17.1 0.62 90.4 ±16.3 0.84 0.54 70.8±17.2 72.6±16.8 0.48 Mental health 72.4±17.6 * * t test * paired-t test J Urol, in press

  7. The health-related quality of life in mothers of enuretic children evaluated with STAI and SDS before and after treatment P value** Before treatment vs. Healthy volunteers P value* Before vs. after treatment Beforetreatment After treatment Healthy volunteers STAI 0.02 0.003 37.3 ±12.8 state 42.0 ±7.8 38.7 ±11.2 trait 0.22 37.7 ±14.2 39.9 ±9.1 37.9 ±11.5 0.20 SDS 0.40 38.7 ±8.2 38.4 ±8.5 0.49 38.0 ±7.3 * paired-t test * * t test J Urol, in press

  8. Sleep and bladder

  9. Dynamic change in bladder capacities in 24 nonenuretics and 36 enuretics Capacity (ml) Nocturnal Bladder Capacity (NBC) Enuretic Bladder Capacity (EBC) Functional Bladder Capacity (FBC) Urology, 2003

  10. Changes in enuretic bladder capacity (EBC) during alarm therapy Ｐ＜0.001 Ｐ＜0.05 Ｐ＜0.01 EBC (ml) Enuresis, 1997

  11. Sleep and Desmopressin

  12. Effect of DDAVP on awakening ability DDAVP 20μg June/1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Time 9 10 11 12 1 2 3 4 5 6 7 8 Am ○ ○ ○ Ｘ ○ Ｘ Ｘ Ｘ Ｘ Ｘ ○：Awakening without wetting×：Bedwetting

  13. Latero-dorsal tegmental nucleus (LDT) response to administration of DDAVP intravenous injection administration Direct Urology 2004

  14. To establish “Brain focused treatment”, causes of NE in CNS should be clarified.

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