Association Between Toilet Training Timing and Prognosis of Nocturnal Enuresis in Children: A Retrospective Study

Toilet training (TT) is a critical developmental milestone with potential implications for lower urinary tract function. However, its association with the prognosis of nocturnal enuresis (NE) remains unclear. We aimed to evaluate whether the timing of TT initiation and completion affects 1-year treatment outcomes in children with NE.

We conducted a retrospective cohort study of 163 children diagnosed with NE between April 2020 and March 2023. Patients were classified into complete response (CR) and non-CR groups based on 1-year treatment outcomes. Data on TT timing, constipation, and daytime incontinence (DI) were obtained from medical records and a structured questionnaire. Statistical analyses included the chi-square test, Mann-Whitney U test, and multivariate logistic regression.

The median age of the cohort was 8 years, and 66.9% of the patients were male. TT was initiated before 3 years of age in 67.5% of patients and completed before 4 years of age in 50.9%. Early TT completion was associated with a significantly lower rate of DI; however, no significant association was observed between TT timing and achievement of CR. In multivariate analysis, neither early TT initiation nor early TT completion independently predicted CR.

Although early TT may be associated with a reduced prevalence of DI, TT timing was not significantly associated with CR at 1 year in this cohort. Constipation and DI were associated with lower odds of CR in the exploratory multivariable analysis.