Is it possible to predict the response to therapy in enuretic children? The PiFe score
Pietro Ferrara1,2, Ignazio Cammisa3, Margherita Zona3
1Department of Medicine and Surgery, Campus Bio-Medico University, Roma, Italy.
Insights
Comorbidities like learning disorders and encopresis predict poor treatment response in children with nocturnal enuresis (NE). A new PiFe score helps predict outcomes and guide interventions for this common childhood condition.
Area of Science:
- Pediatrics
- Urology
- Child Psychology
Background:
- Nocturnal enuresis (NE) affects children over five, with unclear causes including developmental, genetic, and physiological factors.
- Comorbidities are suspected to influence NE management and treatment success.
Purpose of the Study:
- To investigate the impact of comorbidities on nocturnal enuresis.
- To develop a predictive scoring system for treatment response in NE patients.
Main Methods:
- Recruited 374 children (5-18 years) undergoing pharmacological treatment for NE.
- Collected demographic and clinical data via parent interviews.
- Utilized descriptive statistics, chi-squared tests, and logistic regression for analysis.
Main Results:
- Learning disorders were associated with NE recurrence and predicted poor treatment response.
- Encopresis, polythelia, language delay, and snoring also predicted poor treatment response.
- The PiFe score was developed to integrate comorbidities, age, and severity for outcome prediction.
Conclusions:
- A holistic approach is crucial for managing NE, considering associated comorbidities.
- The PiFe score offers a potential clinical tool for predicting NE treatment outcomes.
- Further research is recommended for validation and refinement of the PiFe score.
Introduction:
Nocturnal enuresis (NE) is defined as the involuntary passage of urine during sleep in children over the age of five. Although the precise mechanisms of NE are unclear, factors like delayed development, genetic influences, excessive nighttime urine production, disrupted sleep, and bladder dysfunction play a role. This study aims to evaluate the role of comorbidities in NE and develop a scoring system to predict treatment response, with clinical applications.
Material And Methods:
We recruited 374 patients aged 5-18 years undergoing pharmacological treatment (single or combined) for NE. Demographic and clinical data were collected through parent interviews. Statistical analyses included descriptive statistics and categorical analysis using χ2 tests, followed by logistic regression.
Results:
Statistical associations were found between recurrence and learning disorders (χ2 = 4.862, p = 0.027), and between treatment response and learning disorders, encopresis, polythelia, language delay, and snoring. Logistic regression identified learning disorders (OR = 3.023), encopresis (OR = 2.156), polythelia (OR = 2.196), language delay (OR = 2.137), and snoring (OR = 1.560) as predictors of poor treatment response. We propose the PiFe score, a clinical tool to predict treatment outcomes in children with NE. This score integrates factors such as comorbidities, age, and symptom severity, helping to guide multidisciplinary interventions.
Conclusions:
This study emphasizes the importance of a holistic approach to managing NE. The PiFe score could be a useful tool for predicting treatment outcomes and guiding interventions. Further research is needed to validate and refine the scoring system.
