Effects of Treatment and Weather Variables on Nocturnal Enuresis: Long-Term Analysis Using the Classification and...

Area of Science:

• Pediatric Urology
• Environmental Medicine
• Data Science

Background:

• Nocturnal enuresis (NE), or bedwetting, is a common pediatric condition requiring prolonged treatment.
• Existing research on NE risk factors often overlooks the long-term impact of combined clinical and environmental variables.
• This study addresses the unexplored territory of composite risk factors for NE, including meteorological influences.

Purpose of the Study:

• To investigate composite risk factors for nocturnal enuresis (NE) in pediatric patients.
• To evaluate the long-term effects of combined clinical and meteorological factors on NE.
• To identify potential improvements in NE management strategies.

Main Methods:

• Prospective observational study utilizing unbalanced panel data and the Classification and Regression Trees (CART) model.
• Analysis of 14 months of clinical and meteorological data from 19 pediatric patients (aged 6-15) with NE in Japan.
• Inclusion of demographic variables, five treatment modalities, and six meteorological factors in the risk factor analysis.

Main Results:

• Meteorological variables, specifically daily average ambient temperature and calendar month, were identified as composite factors for NE risk.
• Factors contributing to NE risk included specific treatment histories (e.g., desmopressin without vibegron), treatment duration, absence of alarm therapy, and certain months.
• Vibegron demonstrated potential for greater effectiveness in reducing NE risk compared to other treatments.

Conclusions:

• Effective long-term management of NE necessitates individualized treatment plans.
• Clinical and weather-related variables, including seasonal and environmental factors, should be integrated into NE management.
• Personalized approaches considering both patient-specific clinical data and external environmental conditions are key for successful NE treatment.