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Relationship between primary monosymptomatic enuresis and process toilet training: a case-control
Tânia Antunes Carvalho1, Mônica Maria de Almeida Vasconcelos1, José de Bessa2
1Departamento de Pediatria, Unidade de Nefrologia Pediátrica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.
Insights
Toilet training readiness signals are less remembered in children with primary monosymptomatic nocturnal enuresis (PMNE). A child-oriented approach during toilet training (TT) was found to be protective against PMNE.
Area of Science:
- Pediatrics
- Urology
- Child Development
Background:
- Primary monosymptomatic nocturnal enuresis (PMNE) is a common childhood condition with complex causes.
- Understanding the role of toilet training (TT) in PMNE is crucial for effective management.
Purpose of the Study:
- To investigate the association between the toilet training process and primary monosymptomatic nocturnal enuresis (PMNE) in children and adolescents.
- To identify specific aspects of toilet training that may influence the occurrence of PMNE.
Main Methods:
- A case-control study was conducted between 2015 and 2020.
- 103 children with PMNE and 269 controls without PMNE were included.
- A semi-structured questionnaire assessed toilet training practices.
Main Results:
- Children with PMNE recalled readiness signals less frequently and remembered them less (p=0.001).
- No significant differences were observed in the age of onset for daytime/nocturnal TT, daytime continence acquisition, or equipment used.
- A lower use of the Child-Oriented approach was noted in children with PMNE (OR=0.44, p=0.039).
Conclusions:
- The age of TT onset, daytime continence acquisition, and equipment type were not linked to increased PMNE.
- A Child-Oriented approach to toilet training demonstrated a protective effect against primary monosymptomatic nocturnal enuresis.
Objective:
Primary monosymptomatic nocturnal enuresis (PMNE) is a prevalent condition in childhood, and the pathophysiology is multifactorial. This study investigated the relationship between the toilet training process (TT) and PMNE in children and adolescents.
Patients And Methods:
A case-control study was carried out from 2015 to 2020. The presence of PMNE was identified according to International Children's Continence Society criteria. A semi-structured questionnaire was applied to assess TT.
Results:
The study included 103 children and adolescents with PMNE and 269 participants with normal psychomotor development without PMNE (control group [CG]). Readiness signals were more remembered and less frequent in participants with PMNE (p=0.001) when compared to control group. No differences were found between the groups regarding the onset age of the daytime TT (p= 0.10), the nocturnal TT (p=0.08), the acquisition of daytime continence (p=0.06), and the type of equipment used for the TT (p=0.99). The use of Child-Oriented approach in group of children with enuresis was lower than in controls [87.4% (90/103) versus 94% (250/266)], respectively (OR= 0.44, 95% CI 0.21-0.94, p = 0.039).
Conclusions:
The age of onset of TT, acquisition of daytime continence, and the type of equipment were not associated with higher occurrence of PMNE. On the other hand, the Child-Oriented approach was a protective factor for the occurrence of PMNE.
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