Problems in Treatment of Enuresis

To the Editor:—  Replies to Dr. Cook's inquiry (193:752, 1965) whether electrical apparatuses are recommended in treating nocturnal enuresis, in my opinion, stress excessively psychiatric etiology and seriously overlook organic disease. They do not appreciate fully the central ingredient of sleep, and lean dangerously on the opinion that children "outgrow" their problem.The concept that enuresis is almost always emotionally determined does not withstand, in my judgement, critical examination. Burrows¹ states, "In about half the patients with persistent enuresis an organic abnormality can be found..." Authors with vast experience claim that the stenotic meatus is the first thing to consider in enuresis, and I have found, in a series of 186 cases, a 64% incidence of pertinent disease. The more detailed the medical and urological examination, the higher the incidence of disease found. Deep sleep, by clinical and laboratory studies², is a common denominator.Nor should one