Indonesian Urologists' Current Practice on Nocturnal Enuresis

Nocturnal enuresis (NE) is a symptom and a condition of intermittent incontinence which takes place during periods of sleep. Being the most common form of incontinence in children, the prevalence of NE in Indonesia is 2.3%. The objective of the study was to review Indonesian urologists' current practice on NE. This was a descriptive cross-sectional study using a self-constructed questionnaire which was distributed during several urological scientific meetings from August 2017 until August 2018. Indonesian urologists were asked to fill out these questionnaires which contained characteristics of the respondents and NE patients they had seen in their practices, diagnostic modalities and treatment options for NE. 133 out of 400 urologists participated. Most urologists had to deal with 1-5 cases NE per month. It was most commonly seen in 5-10 age group and affecting more girls than boys (45.9% vs 27.8% respectively). Approximately only half of Indonesian urologists utilized bladder diary for NE cases. Almost 90% urologist educated and proposed lifestyle intervention to manage NE. Alarm therapy and desmopressin was chosen by 51.1% and 21.8% of urologists respectively as treatment. Desmopressin was still less commonly prescribed compared to antimuscarinic and beta 3 agonist. To conclude, diagnostic strategies for NE are mostly in accordance with available guidelines although bladder diary was only opted by approximately half of urologists. Regarding treatment, education, lifestyle intervention and alarm therapy were the most form of treatment utilized for this condition.Praktik Terkini Spesialis Urologi Indonesia dalam Menangani Enuresis Nokturnal  Enuresis nokturnal adalah bentuk inkontinensia urine intermiten yang terjadi saat tidur yang merupakan inkontinensia urine tersering pada anak dengan prevalensi di Indonesia 2,3%. Tujuan penelitian ini adalah mengetahui praktik terkini dokter spesialis urologi dalam menangani enuresis nokturnal. Studi deskriptif potong lintang ini menggunakan kuesioner yang dibagikan pada dokter spesialis urologi pada bulan Agustus 2017–Agustus 2018. Sebanyak 133 dari 400 spesialis urologi berpartisipasi dalam studi ini. Mayoritas spesialis urologi mendapat 1-5 kasus enuresis nokturnal per bulan. Usia pasien tersering adalah 5-10 tahun dan lebih banyak anak perempuan dibandingkan anak laki-laki (45,9% vs 27,8%). Setengah spesialis urologi menggunakan catatan harian berkemih untuk diagnosis enuresis nokturnal. Hampir 90% responden memilih edukasi dan intervensi gaya hidup sebagai tata laksana. Terapi alarm dan desmopressin digunakan oleh 51,1% dan 21,8% responden untuk terapi. Anti-muskarinik dan beta-3-agonis lebih sering diberikan dibandingkan desmopressin. Disimpulkan strategi diagnostik untuk enuresis nokturnal telah sesuai dengan panduan tata laksana kecuali untuk catatan harian berkemih. Terapi yang paling banyak dipilih adalah edukasi, intervensi gaya hidup, dan terapi alarm.&nbsp

The Management of Nocturia by Indonesian Urologist

Nocturia is defined as the number of times urine is passed during main sleep. Prevalence of nocturia is around 70% and 11-44% for age group 70-80 and 20-40 years respectively. Although, it is clearly prevalent, nocturia is just seen as a small part of lower urinary tract symptoms (LUTS). The objective of the study was to review nocturia in terms of diagnostic and management strategies among Indonesian urologists. This was a descriptive cross-sectional study. A self-constructed questionnaire was distributed to Indonesian urologists from August 2017 until August 2018 using consecutive sampling method. 124 urologists out of 400 urologists participated. in this study most of the urologists had to face 1-5 cases nocturia per month. Age of patients were mostly 50-65 years old and affecting more men than women (66.9% vs 16.9% respectively). Only 45% of urologists utilized bladder diary regularly to assess nocturia. Nearly 90% urologist opted for lifestyle intervention to manage nocturia. Desmopressin was used by only 20.2% urologists to treat nocturia. Anti-muscarinic and beta-3 agonist were used more often than desmopressin to treat nocturia. To conclude, diagnostic strategies for nocturia are mostly in line with available guidelines except for bladder diary which was only used routinely by 45% of urologists. As for treatment, desmopressin was still prescribed less frequently than OAB drugs for nocturia