Search Results (3)

Introduction: Nocturnal enuresis is defined as involuntary urination during sleep in children, particularly those aged 5 years or older. Primary monosymptomatic nocturnal enuresis (PMNE) involves nighttime wetting without daytime symptoms, and although factors like reduced bladder capacity, nocturnal polyuria, and impaired arousal contribute, predictors of long-term relapse remain uncertain. Methods: This retrospective cohort study included 227 children aged ≥5 years with strictly defined PMNE who achieved complete remission following a standardized 3-month treatment protocol (alarm therapy, desmopressin, or desmopressin plus oxybutynin). All children underwent ICCS-based assessment, including physical examination, urinalysis, ultrasonography, UFM, a 48 h frequency/volume (F/V) diary, and post-void residual measurement. One year after treatment discontinuation, patients were reassessed using a 14-day wet-night diary. Predictors of relapse were analyzed using comparative statistics. Result: At 1-year follow-up, 48.5% of children experienced relapse. Age, sex, treatment modality, family history, and baseline wet-night frequency were not associated with relapse (p > 0.05). Diary-based FBC was significantly higher than UFM-based capacity (p < 0.001). Reduced diary-based mean FBC/EBC ratios were significantly more common among relapsing children (p < 0.001), whereas UFM-derived ratios showed no significant difference (p = 0.052). ROC analysis demonstrated moderate discriminatory performance for diary-based FBC/EBC (AUC 0.671). A ratio > 79% predicted sustained remission with 83.6% specificity and a positive predictive value of 73.5%. Conclusions: Diary-derived bladder capacity is the strongest predictor of long-term relapse in PMNE and outperforms UFM-based assessment. A mean FBC/EBC ratio > 79% provides a clinically useful threshold for identifying children at low risk of recurrence. Those with reduced diary-based capacity may benefit from closer follow-up or extended maintenance therapy. Full article

Background/Objectives: A subset of children with monosymptomatic nocturnal enuresis (MNE) remains unresponsive to standard treatments such as desmopressin and alarm therapy. This study aimed to identify clinical predictors of response to biofeedback therapy in treatment-resistant MNE and to evaluate the role of bladder capacity as a stratification parameter. Methods: In this prospective study, 89 children with treatment-resistant MNE underwent six weekly sessions of biofeedback therapy involving visual pelvic floor feedback. Based on treatment outcomes, patients were classified as complete responders or partial/non-responders. Clinical characteristics including age-adjusted maximal voided volume (MVV), nocturnal polyuria, and wetting frequency were compared. Results: Patients with a complete response had significantly lower baseline MVV and age-adjusted MVV (p < 0.001). Nocturnal overactivity was more common among responders (60.6% vs. 33.9%, p = 0.017), whereas nocturnal polyuria was more frequent in non-responders (p = 0.027). Age-adjusted MVV emerged as the only independent predictor of treatment success in multivariate analysis (p = 0.045), with ROC analysis confirming its predictive value (AUC = 0.767, 95% CI: 0.667–0.866). Conclusions: These findings suggest that reduced bladder capacity and frequent night-time wetting may help identify patients who are more likely to benefit from biofeedback therapy. Bladder capacity assessment may thus serve as a useful tool in tailoring management strategies for refractory MNE. Full article

Around 15% of children still wet their bed after five years old. Although bedwetting alarms have proven to be effective to achieve nighttime dryness, they are cumbersome so children could be reluctant to use them. Therefore, the moisture sensor and wire were made unobtrusive by seamlessly integrated them into fully textile underwear by using conductive yarns. Consequently, the alarm acceptability should be enhanced by improving children’s comfort. Three conductive textile metallic yarns, made of silver or stainless steel, were considered to fabricate the urine leakage sensor. Silver-plated-nylon yarn, which showed the highest electrical conductivity, outperformed the stainless-steel yarns regarding its ability to detect urine leakage as well as its detection speed. Furthermore, it was proven to withstand multiple urine soakings and the following machine-washings, even at high temperature (60 °C). However, the electrical current, necessary to detect the leakage, tends to corrode the silver. Therefore, the detection circuit was adapted. Eventually, the designed leakage sensor was seamlessly integrated into a child’s trunk underwear, into which a miniaturized alarm can be plugged. The resulting textile underwear aims at replacing the rigid alarm system currently available, hence improving the quality of life of enuretic children and help them achieving nighttime dryness. Full article