Nocturnal enuresis: application of evidence-based medicine in community practice
David A Cutting1, Julie F Pallant, Felicity M Cutting
1Paediatric Practice, Lilydale, Australia. dac@cambridgekids.com.au
Insights
Body-worn alarms and supportive programs effectively treat children with monosymptomatic nocturnal enuresis (MNE), achieving high initial dryness rates and sustained long-term results. This approach offers a successful, non-pharmacological management option for bedwetting.
Area of Science:
- Pediatric Urology
- Sleep Medicine
- Behavioral Therapy
Background:
- Monosymptomatic nocturnal enuresis (MNE) affects a significant number of children.
- Current management strategies vary, with a need for effective, non-pharmacological options.
Purpose of the Study:
- To evaluate the 2-year outcomes of children with MNE treated with body-worn alarms and a supportive program.
- To assess the effectiveness and long-term success rates of this management approach in a community pediatric practice.
Main Methods:
- Prospective data collection from 522 children with MNE managed using body-worn alarms and a comprehensive supportive program.
- Outcomes, including initial dryness and relapse rates, were assessed at 6 and 24 months.
Main Results:
- 79% of children achieved initial dryness within 10 weeks; 64% remained dry at 24 months.
- Success rates were not influenced by initial severity or age, but girls achieved dryness faster.
- Relapse rates at 6 and 24 months were not associated with gender, age, or initial severity.
Conclusions:
- Body-worn alarms combined with supportive programs provide successful initial and long-term dryness for MNE.
- This non-pharmacological intervention is effective and can reduce the burden of management for families.
- High follow-up rates (99.2%) support the reliability of the findings.
Aim:
To report the outcomes and follow-up at 2 years of children with monosymptomatic nocturnal enuresis (MNE) managed in a private paediatric community practice utilising body-worn alarms and supportive programmes.
Methods:
522 consecutive children presenting with MNE were assessed and managed with a comprehensive supportive programme and body-worn alarm. Data were recorded prospectively and outcomes assessed at 6 and 24 months.
Results:
505 proceeded with management. A total of 79.0% achieved initial dryness within a median of 10 weeks. Of those achieving initial dryness 73.0% had remained dry at 6-month follow-up and 64% had remained dry at 24 months. A total of 99.2% follow-up was achieved. Nineteen per cent of children required more than 16 weeks management with 56% achieving dryness. More girls achieved dryness than boys and in a shorter time. There was no gender difference in relapse rates at 6 and 24 months. No difference in achieving initial success was found with respect to initial severity of wetting, nor age. Relapse rates were unrelated to gender, age, or initial severity.
Conclusion:
MNE can be successfully managed using body-worn alarms achieving good initial and long-term complete dryness, without the need for expensive pharmacologic intervention. A strong supportive programme can make the management less arduous for child and family.
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