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Effect of Multidisciplinary Assessment on Paediatric Patients with Monosymptomatic Nocturnal Enuresis
1Department of Child & Adolescent Psychiatry, Wuhan Mental Health Center (Wuhan Hospital for Psychotherapy), 430012 Wuhan, Hubei, China.
Insights
Multidisciplinary assessment identifies more children with enuresis caused by other conditions. This approach significantly improves treatment response rates and quality of life for paediatric patients with monosymptomatic nocturnal enuresis (MNE).
Area of Science:
- Pediatrics
- Urology
- Sleep Medicine
Background:
- Monosymptomatic nocturnal enuresis (MNE) affects many children, impacting their quality of life.
- Accurate diagnosis and tailored treatment are crucial for effective management of MNE.
Purpose of the Study:
- To evaluate the impact of a multidisciplinary assessment approach on the diagnosis and treatment of paediatric patients with MNE.
- To compare the effectiveness of multidisciplinary assessment versus routine assessment in identifying underlying conditions and treatment responses.
Main Methods:
- A retrospective study of 242 paediatric patients with enuresis, divided into multidisciplinary (n=130) and routine (n=112) assessment groups.
- Multidisciplinary assessment included comprehensive evaluations: history, physical/neurological exams, diaries, questionnaires, psychological assessments, imaging, lab tests, polysomnography, and balance assessments.
- Routine assessment involved standard diagnostic procedures.
Main Results:
- The multidisciplinary group identified a higher proportion of patients with enuresis associated with other conditions (27.7% vs 15.2%, p=0.019).
- Significantly higher treatment response rates were observed in the multidisciplinary group for enuresis alarms (82.1% vs 52.9%, p=0.028), desmopressin (83.3% vs 52.0%, p=0.022), and combination therapy (74.2% vs 44.4%, p=0.045).
- The multidisciplinary group showed significantly higher Pediatric Quality of Life Inventory (PedsQL 4.0) scores post-treatment (91.9 vs 87.1, p<0.001).
Conclusions:
- Multidisciplinary evaluation enhances the differential diagnosis of MNE by identifying more children with co-existing conditions.
- This comprehensive approach leads to improved treatment outcomes and better quality of life for children with MNE.
Objective:
This study aimed to investigate the effect of multidisciplinary assessment in paediatric patients with monosymptomatic nocturnal enuresis (MNE).
Methods:
From July 2018 to June 2021, 242 patients with enuresis who received diagnosis and treatment in our hospital were retrospectively enrolled. They were divided into the multidisciplinary assessment group (n = 130) and routine assessment group (n = 112). Multidisciplinary assessments were completed by a multidisciplinary team, and the data included structured medical history, physical and neurological examinations, bladder and bowel diaries, sleep diaries, questionnaires, psychological assessments, urinary ultrasonography, blood and urine laboratory tests, polysomnography and balance assessments.
Results:
A higher proportion of patients with enuresis associated with other conditions was identified in the multidisciplinary assessment group than in the routine assessment group (27.7% vs 15.2%, p = 0.019). With regard to treatment response to the enuresis alarm, the treatment response rate was 52.9% (17/33) in the conventional assessment group, whereas such a response was significantly higher in the multidisciplinary assessment group (82.1%, 32/39; p = 0.028). Compared with the routine assessment group, the multidisciplinary assessment group had a significantly higher treatment response rate for desmopressin (83.3% vs 52.0%; p = 0.022) and alarms combined with desmopressin (74.2% vs 44.4%; p = 0.045). After treatment, the Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0) score in the multidisciplinary assessment group was significantly higher than that in the routine assessment group (91.9 ± 6.3 vs 87.1 ± 7.3; p < 0.001).
Conclusions:
Multidisciplinary evaluation can identify more children with enuresis caused by other diseases, which promotes the differential diagnosis of MNE. In addition, multidisciplinary assessment can determine the appropriate treatment response in children with MNE.
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