Dataset Information

Daytime urotherapy in nocturnal enuresis: a randomised, controlled trial.

ABSTRACT:

Objective

According to international guidelines, children with enuresis are recommended urotherapy, or basic bladder advice, before treatment with evidence-based alternatives such as the enuresis alarm is given. The efficacy of this strategy has, however, not been supported by controlled studies. We wanted to test if basic bladder advice is useful in enuresis.

Design

Randomised, controlled trial.

Setting

Paediatric outpatient ward, regional hospital.

Patients

Treatment-naïve enuretic children aged ≥6 years, with no daytime incontinence.

Interventions

Three groups, each during 8 weeks: (A) basic bladder advice-that is, voiding and drinking according to a strict schedule and instructions regarding toilet posture, (B) enuresis alarm therapy and (C) no treatment (control group).

Main outcome measures

Reduction in enuresis frequency during week 7-8 compared with baseline.

Results

The median number of wet nights out of 14 before and at the end of treatment were in group A (n=20) 12.5 and 11.5 (p=0.44), in group B (n=22) 11.0 and 3.5 (p<0.001) and in group C (n=18) 12.5 and 12.0 (p=0.55). The difference in reduction of enuresis frequency between the groups was highly significant (p=0.002), but no difference was found between basic bladder advice and controls.

Conclusions

Urotherapy, or basic bladder advice, is ineffective as a first-line treatment of nocturnal enuresis. Enuretic children who are old enough to be bothered by their condition should be offered treatment with the alarm or desmopressin.

Trial registration number

NCT03812094.

SUBMITTER: Borgstrom M

PROVIDER: S-EPMC9125372 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Daytime urotherapy in nocturnal enuresis: a randomised, controlled trial.

Borgström Malin M Bergsten Amadeus A Tunebjer Maria M Hedin Skogman Barbro B Nevéus Tryggve T

Archives of disease in childhood 20220124 6

<h4>Objective</h4>According to international guidelines, children with enuresis are recommended urotherapy, or basic bladder advice, before treatment with evidence-based alternatives such as the enuresis alarm is given. The efficacy of this strategy has, however, not been supported by controlled studies. We wanted to test if basic bladder advice is useful in enuresis.<h4>Design</h4>Randomised, controlled trial.<h4>Setting</h4>Paediatric outpatient ward, regional hospital.<h4>Patients</h4>Treatme ...[more]

PMID: 35074830

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Project description:BackgroundNocturnal enuresis is an important problem among young children living in Turkey. The purpose of this study was to determine the possible differences in the prevalence of enuresis between children in boarding school and daytime school and the association of enuresis with sociodemographic factors.MethodsThis was a cross-sectional survey. A total of 562 self-administered questionnaires were distributed to parents from two different types of schools. One of them was a day-time school and the other was a boarding school. To describe enuresis the ICD-10 definition of at least one wet night per month for three consecutive months was used. Chi-square test and a logistic regression model was used to identify significant predictive factors for enuresis.ResultsThe overall prevalence of nocturnal enuresis was 14.9%. The prevalence of nocturnal enuresis declined with age. Of the 6 year old children 33.3% still wetted their beds, while the ratio was 2.6% for 15 years-olds. There was no significant difference in prevalence of nocturnal enuresis between boys and girls (14.3% versus 16. 8%). Enuresis was reported as 18.5% among children attending day time school and among those 11.5% attending boarding school (p < 0.05). Prevalence of enuresis was increased in children living in villages, with low income and with positive family history (p < 0.05). After multivariate analysis, history of urinary tract infection (OR = 2.02), age (OR = 1.28), low monthly income (OR = 2.86) and family history of enuresis (OR = 3.64) were factors associated with enuresis. 46.4% of parents and 57.1% of enuretic children were significantly concerned about the impact of enuresis.ConclusionEnuresis was more frequent among children attending daytime school when compared to boarding school. Our findings suggest that nocturnal enuresis is a common problem among school children, especially with low income, smaller age, family history of enuresis and history of urinary tract infection. Enuresis is a pediatric public health problem and efforts at all levels should be made such as preventive, etiological and curative.

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Dataset Information

Daytime urotherapy in nocturnal enuresis: a randomised, controlled trial.

Objective

Design

Setting

Patients

Interventions

Main outcome measures

Results

Conclusions

Trial registration number

Publications

Daytime urotherapy in nocturnal enuresis: a randomised, controlled trial.

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