{"id":2912,"date":"2015-06-25T19:22:39","date_gmt":"2015-06-25T19:22:39","guid":{"rendered":"http:\/\/pipi-stop.version-demo.ch\/?page_id=2912"},"modified":"2021-03-30T09:44:36","modified_gmt":"2021-03-30T09:44:36","slug":"should-be-treated","status":"publish","type":"page","link":"https:\/\/www.pipi-stop.ch\/en\/bedwetting\/should-be-treated\/","title":{"rendered":"Should be treated?"},"content":{"rendered":"

[et_pb_section fb_built=”1″ module_id=”h3-petit” module_class=”main-h1-title” _builder_version=”3.22″ background_color=”#ffffff” transparent_background=”off”][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text admin_label=”h1″ _builder_version=”3.27.4″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” text_orientation=”center” module_alignment=”center”]<\/p>\n

Should be Treated?<\/h1>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” column_structure=”3_4,1_4″][et_pb_column type=”3_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text admin_label=”Texte” _builder_version=”3.27.4″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”]<\/p>\n

Even if most of the time bedwetting is not caused by upbringing or psychological disorders, it can in the long term upset the child.<\/p>\n

When the child feels different than others, when he\/she cannot take part in certain activities (go to a camp with the school, sleep at a friend’s place, etc.), this can cause your child a loss of self-confidence.<\/p>\n

The risk is that your child’s demotivation develops a chain effect affecting other areas of his life. Therefore, when bedwetting is not cured, it can lead to psychological problems.<\/p>\n

If your child still wets regularly his bed after 5 years of age, it is recommended to seek advice from your doctor. He will detect the reasons of the enuresis of your child and will indicate the appropriate treatment.<\/p>\n

Help in case of bedwetting (enuresis)<\/a><\/strong>, Source: Dr med. Jean-Pierre Guignard, Honorary Professor of Paediatric nephrology, University of Lausanne<\/em>
\n[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_image src=”https:\/\/www.pipi-stop.ch\/wp-content\/uploads\/2015\/04\/Lapin-sous-coussin-4.jpg” align_tablet=”center” align_last_edited=”on|desktop” admin_label=”Image” _builder_version=”3.23″ animation_style=”slide” animation_direction=”right” animation_duration=”500ms” animation_intensity_slide=”10%” animation=”right” sticky=”off”][\/et_pb_image][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_divider color=”#c4c4c4″ disabled_on=”on|on|off” admin_label=”S\u00e9parateur” module_id=”vergleich” _builder_version=”3.2″][\/et_pb_divider][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text admin_label=”Texte” _builder_version=”3.27.4″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” text_orientation=”center” module_alignment=”center”]<\/p>\n

Actually two therapies are used for the treatment of bedwetting<\/h2>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” column_structure=”1_2,1_2″][et_pb_column type=”1_2″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_image src=”https:\/\/www.pipi-stop.ch\/wp-content\/uploads\/2014\/12\/alarme-enfant_32.jpg” align_tablet=”center” align_last_edited=”on|desktop” admin_label=”Image” _builder_version=”3.23″ animation=”off” sticky=”off”][\/et_pb_image][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_image src=”https:\/\/www.pipi-stop.ch\/wp-content\/uploads\/2014\/12\/pillules.jpg” align_tablet=”center” align_last_edited=”on|desktop” admin_label=”Image” _builder_version=”3.23″ animation=”off” sticky=”off”][\/et_pb_image][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” column_structure=”1_2,1_2″][et_pb_column type=”1_2″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text admin_label=”Texte” _builder_version=”4.9.0″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” hover_enabled=”0″ sticky_enabled=”0″]<\/p>\n

The behavioural treatment with an alarm-system (Pipi-Stop)<\/strong><\/h3>\n

With the alarm-system Pipi-Stop we do a natural training of the continence system. The child develops the reflex to retain his urine, the capacity of the bladder increases and the urine is more concentrated (Prof. G\u00e9rard Lenoir’s opinion<\/a><\/strong>).<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text admin_label=”Texte” _builder_version=”3.27.4″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”]<\/p>\n

The medical treatment with the active substance desmopressine<\/strong><\/h3>\n

This substance is administrated in form of tablet(s). This is an antidiuretic hormone (ADH) which can diminish the urine production during the sleep.
\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” column_structure=”1_2,1_2″][et_pb_column type=”1_2″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_counters admin_label=”Compteur barre” _builder_version=”3.0.87″ background_color=”#dddddd” custom_padding=”|||” custom_padding_tablet=”|||” custom_padding_phone=”|||” custom_padding_last_edited=”off|desktop”][et_pb_counter percent=”90″ _builder_version=”3.0.47″ background_color_default=”#dddddd” background_enable_color_default=”on” parallax_default=”off” parallax_method_default=”on” bar_background_color_default=”#00579f” use_percentages=”on” allow_player_pause_default=”off”]Rate of success[\/et_pb_counter][et_pb_counter percent=”5″ _builder_version=”3.0.47″ background_color_default=”#dddddd” background_enable_color_default=”on” parallax_default=”off” parallax_method_default=”on” bar_background_color_default=”#00579f” use_percentages=”on” allow_player_pause_default=”off”]Relapses[\/et_pb_counter][et_pb_counter _builder_version=”3.0.47″ background_color_default=”#dddddd” background_enable_color_default=”on” parallax_default=”off” parallax_method_default=”on” bar_background_color_default=”#00579f” use_percentages=”on” allow_player_pause_default=”off”]Secondary effects[\/et_pb_counter][\/et_pb_counters][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_counters bar_bg_color=”#f68e00″ admin_label=”Compteur barre” _builder_version=”3.0.87″ background_color=”#dddddd” custom_padding=”|||” custom_padding_tablet=”|||” custom_padding_phone=”|||” custom_padding_last_edited=”off|desktop”][et_pb_counter percent=”65″ _builder_version=”3.0.47″ background_color_default=”#dddddd” background_enable_color_default=”on” parallax_default=”off” parallax_method_default=”on” bar_background_color_default=”#f68e00″ use_percentages=”on” allow_player_pause_default=”off”]Rate of success[\/et_pb_counter][et_pb_counter percent=”50″ _builder_version=”3.0.47″ background_color_default=”#dddddd” background_enable_color_default=”on” parallax_default=”off” parallax_method_default=”on” bar_background_color_default=”#f68e00″ use_percentages=”on” allow_player_pause_default=”off”]Relapses[\/et_pb_counter][et_pb_counter percent=”7″ _builder_version=”3.0.47″ background_color_default=”#dddddd” background_enable_color_default=”on” parallax_default=”off” parallax_method_default=”on” bar_background_color_default=”#f68e00″ use_percentages=”on” allow_player_pause_default=”off”]Secondary effects[\/et_pb_counter][\/et_pb_counters][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_divider color=”#c4c4c4″ disabled_on=”on|on|off” admin_label=”S\u00e9parateur” _builder_version=”3.2″][\/et_pb_divider][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text admin_label=”Texte” _builder_version=”3.27.4″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” text_orientation=”center” module_alignment=”center”]<\/p>\n

The advantages of the therapy with the alarm system<\/h2>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” column_structure=”1_2,1_2″][et_pb_column type=”1_2″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text admin_label=”Texte” _builder_version=”4.9.0″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” hover_enabled=”0″ sticky_enabled=”0″]<\/p>\n

\n

Effectiveness<\/h3>\n

Many paediatricians confirm that the alarm-system is by far the most effective way for the treatment of enuresis, with the least of relapses after the treatment.<\/p>\n<\/div>\n

\n

At the present moment, doctors tend to propose for the treatment of enuresis a method based on a learning process rather than to use medicine. The French research ANAES<\/a> from 2003, evaluated the effectiveness, the security and the economic consequences of the use of alarm-systems for the treatment of the nocturnal enuresis in comparison with the treatment with the antidiuretic hormone (desmopressine).<\/p>\n

These research findings (ANAES, p. 37) show that the substance desmopressine has a certain effect during the treatment, but that these effects diminish rapidly after having stopped the medicine and that, on the long term, the alarm-system proves to be more effective: 50% of the patients treated with desmopressine relapsed after the treatment against\u00a0only 5% of the patients treated with the alarm-system.<\/p>\n

According to the\u00a0Cochrane research<\/a>, a relapse is 9 times less probaly with the alarm-system than with the antidiuretic hormone.<\/p>\n

See the different researches<\/a><\/strong><\/p>\n<\/div>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text admin_label=”Texte” _builder_version=”3.27.4″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”]<\/p>\n

Security<\/h3>\n

The alarm-system does not generate secondary effects.<\/p>\n

With the antidiuretic hormone secondary effects have been observed with about 7% of treated children: espesially headache, sickness, abdominal pains, skin rashes, etc. Very rarely a water intoxication was established.<\/p>\n

The antidiuretic hormones as a nasal spray, already removed from the market in many european countries, are not anymore proposed in Switzerland for the treatment of the enuresis because of their significant secondary effects.<\/p>\n

See Research<\/a><\/strong>\u00a0 ANAES, France: full research, p. 17<\/p>\n

Economic consequences<\/h3>\n

In Switzerland a 3-month treatment (based on an average daily dose of the antidiuretic hormone), is significantly more expensive than the use of the alarm-system pipi-stop.<\/p>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"

Should be Treated? Even if most of the time bedwetting is not caused by upbringing or psychological disorders, it can in the long term upset the child. When the child feels different than others, when he\/she cannot take part in certain activities (go to a camp with the school, sleep at a friend’s place, etc.), […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":2910,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"

[et_pb_section transparent_background=\"off\" background_color=\"#ffffff\" allow_player_pause=\"off\" inner_shadow=\"off\" parallax=\"off\" parallax_method=\"off\" module_class=\"main-h1-title\" module_id=\"h3-petit\"][et_pb_row][et_pb_column type=\"4_4\"][et_pb_text admin_label=\"h1\" background_layout=\"light\" text_orientation=\"center\"]<\/p>

\u00a0Muss man behandeln?<\/h1>

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row][et_pb_column type=\"3_4\"][et_pb_text admin_label=\"Texte\" background_layout=\"light\" text_orientation=\"left\"]<\/p>

Auch wenn sich in den meisten F\u00e4llen das Bettn\u00e4ssen nicht aus der Erziehung oder einer psychologischen St\u00f6rung ergibt, kann es auf die L\u00e4nge das Kind belasten.

Wenn es sich anders als die anderen Kinder f\u00fchlt, wenn es an gewissen Aktivit\u00e4ten nicht mehr teilnehmen kann (mit der Schule in ein Lager gehen, bei einem Freund oder einer Freundin \u00fcbernachten, usw.), kann dies zu einem Verlust an Selbstvertrauen f\u00fchren.<\/p>

Das Risiko besteht dann, dass Ihr Kind in eine Spirale der Entmutigung gelangt und dass sich dies auch auf andere Bereiche seines Lebens auswirkt. Eine n\u00e4chtliche Enuresis, die nicht behandelt wird, kann also psychologische Probleme ausl\u00f6sen.<\/p>

Wenn Ihr Kind nach seinem 5. Geburtstag noch regelm\u00e4ssig sein Bett n\u00e4sst, ist ein Arztbesuch empfohlen. Der Arzt kann die Ursachen der Enuresis Ihres Kindes feststellen und Sie \u00fcber die richtige Behandlung orientieren.<\/p><\/div>

[\/et_pb_text][\/et_pb_column][et_pb_column type=\"1_4\"][et_pb_image admin_label=\"Image\" src=\"http:\/\/www.pipi-stop.ch\/wp-content\/uploads\/2015\/04\/Lapin-sous-coussin-4.jpg\" show_in_lightbox=\"off\" url_new_window=\"off\" animation=\"right\" sticky=\"off\" \/][\/et_pb_column][\/et_pb_row][et_pb_row][et_pb_column type=\"4_4\"][et_pb_divider admin_label=\"S\u00e9parateur\" color=\"#c4c4c4\" show_divider=\"on\" \/][\/et_pb_column][\/et_pb_row][et_pb_row][et_pb_column type=\"4_4\"][et_pb_text admin_label=\"Texte\" background_layout=\"light\" text_orientation=\"center\"]<\/p>

Zurzeit werden zwei Therapien f\u00fcr die Behandlung der Enuresis angewendet<\/h2>

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row][et_pb_column type=\"1_2\"][et_pb_image admin_label=\"Image\" src=\"http:\/\/www.pipi-stop.ch\/wp-content\/uploads\/2014\/12\/alarme-enfant_32.jpg\" show_in_lightbox=\"off\" url_new_window=\"off\" animation=\"off\" sticky=\"off\" \/][\/et_pb_column][et_pb_column type=\"1_2\"][et_pb_image admin_label=\"Image\" src=\"http:\/\/www.pipi-stop.ch\/wp-content\/uploads\/2014\/12\/pillules.jpg\" show_in_lightbox=\"off\" url_new_window=\"off\" animation=\"off\" sticky=\"off\" \/][\/et_pb_column][\/et_pb_row][et_pb_row][et_pb_column type=\"1_2\"][et_pb_text admin_label=\"Texte\" background_layout=\"light\" text_orientation=\"left\"]<\/p>

Apparative Verhaltenstherapie (mit einem Pipi-Stop Weckapparat)<\/h3>

Mit dem Weckapparat wird das Kontinenzsystem auf nat\u00fcrliche Weise trainiert. Das Kind lernt den Reflex seinen Urin zur\u00fcckzuhalten, die Kapazit\u00e4t der Blase wird gr\u00f6sser und der Urin konzentrierter. [\/et_pb_text][\/et_pb_column][et_pb_column type=\"1_2\"][et_pb_text admin_label=\"Texte\" background_layout=\"light\" text_orientation=\"left\"]<\/p>

Medikament\u00f6se Behandlung mit dem Wirkstoff Desmopressin<\/h3>

Er wird als Tabletten verabreicht. Es handelt sich um ein antidiuretisches Hormon (ADH), das die Urinmenge w\u00e4hrend des Schlafs reduzieren kann. [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row][et_pb_column type=\"1_2\"][et_pb_counters admin_label=\"Compteur barre\" background_layout=\"light\" background_color=\"#dddddd\" bar_bg_color=\"#00579f\"][et_pb_counter percent=\"90\"]Erfolgsraten[\/et_pb_counter][et_pb_counter percent=\"5\"]R\u00fcckf\u00e4lle[\/et_pb_counter][et_pb_counter percent=\"0\"]Nebenwirkungen[\/et_pb_counter][\/et_pb_counters][\/et_pb_column][et_pb_column type=\"1_2\"][et_pb_counters admin_label=\"Compteur barre\" background_layout=\"light\" background_color=\"#dddddd\" bar_bg_color=\"#f68e00\"][et_pb_counter percent=\"65\"]Erfolgsraten[\/et_pb_counter][et_pb_counter percent=\"50\"]R\u00fcckf\u00e4lle[\/et_pb_counter][et_pb_counter percent=\"7\"]Nebenwirkungen[\/et_pb_counter][\/et_pb_counters][\/et_pb_column][\/et_pb_row][et_pb_row][et_pb_column type=\"4_4\"][et_pb_divider admin_label=\"S\u00e9parateur\" color=\"#c4c4c4\" show_divider=\"on\" \/][\/et_pb_column][\/et_pb_row][et_pb_row][et_pb_column type=\"4_4\"][et_pb_text admin_label=\"Texte\" background_layout=\"light\" text_orientation=\"center\"]<\/p>

Die Vorteile der Therapie mit Weckapparat<\/h2>

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row][et_pb_column type=\"1_2\"][et_pb_text admin_label=\"Texte\" background_layout=\"light\" text_orientation=\"left\"]<\/p>

Wirkung<\/h3>

Viele Kinder\u00e4rzte best\u00e4tigen, dass zur Behandlung der Enuresis der Weckapparat bei weitem das wirksamste Mittel ist, und gleichzeitig auch das, welches am wenigsten R\u00fcckf\u00e4lle aufweist.<\/p><\/div>

Nach der aktuellen Tendenz, w\u00e4hlen die \u00c4rzte zur Behandlung der n\u00e4chtlichen Enuresis eher eine Methode, die auf einem Lernprozess basiert, anstatt Medikamente anzuwenden. Die franz\u00f6sische Studie ANAES<\/a>, die 2003 abgeschlossen wurde, hat die Wirkung, die Sicherheit und die wirtschaftlichen Konsequenzen des Gebrauchs der Alarmsysteme (Weckapparate) in der Behandlung der n\u00e4chtlichen Enuresis im Vergleich zu deren durch das antidiuretische Hormon (Desmopressin) bewertet.<\/p>

Diese Studie (ANAES, S. 37) hat hervorgehoben, dass der Wirkstoff Desmopressin w\u00e4hrend der Behandlung eine gewisse Wirkung hat, aber dass diese beim Einstellen des Medikaments schnell nachl\u00e4sst und dass langfristig gesehen, der Weckapparat wirksamer ist: 50% der Patienten, die mit Dessmopressin behandelt wurden, verzeichneten R\u00fcckf\u00e4lle, im Gegensatz nur 5% f\u00fcr die mit dem Alarm (Weckapparat) behandelten Patienten.<\/p>

Laut Cochrane Studie<\/a> ist mit dem Weckapparat die Wahrscheinlichkeit eines R\u00fcckfalls 9-mal geringer als mit dem antidiuretischen Hormon.<\/p>Siehe die verschiedenen\u00a0Studien<\/a><\/strong><\/div>

[\/et_pb_text][\/et_pb_column][et_pb_column type=\"1_2\"][et_pb_text admin_label=\"Texte\" background_layout=\"light\" text_orientation=\"left\"]<\/p>

Sicherheit<\/h3>

Der Weckapparat verursacht keine Nebenwirkungen.<\/p>

Mit dem antidiuretischen Hormon wurden bei ungef\u00e4hr 7% der behandelten Kindern Nebenwirkungen beobachtet, wie Kopfschmerzen, \u00dcbelkeit, Bauchschmerzen, Hautausschl\u00e4ge, etc. In sehr seltenen F\u00e4llen wurde eine Wasserintoxikation festgestellt.<\/p>

Das antidiuretische Hormon als Nasenspray (in vielen europ\u00e4ischen L\u00e4ndern schon l\u00e4nger vom Markt genommen) wird nun auch in der Schweiz wegen den betr\u00e4chtlichen Nebenwirkungen f\u00fcr die Behandlung des Bettn\u00e4ssens nicht mehr angeboten.<\/p>

Siehe Studie<\/a><\/strong> ANAES, Frankreich: vollst\u00e4ndige Studie, S. 17<\/p>

Wirtschaftliche Konsequenzen<\/h3>

In der Schweiz, im Vergleich zwischen einer 3-monatigen Behandlung (basierend auf einer durchschnittlichen t\u00e4glichen Dosis im Falle des Medikaments), ergibt sich folgendes Resultat: Die Behandlungskosten mit dem Weckapparat sind wesentlich geringer.<\/p>

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