Predictors of severity and treatment response in children with monosymptomatic nocturnal enuresis receiving behavioral therapy

• Published in: Journal of pediatric urology 2012-02, Vol.8 (1), p.29-34
• Main Authors: Elsayed, Ehab R, Abdalla, Mohamed M.H, Eladl, Mahmoud, Gabr, Ahmed, Siam, Ahmed G, Abdelrahman, Hosam M
• Format: Article
• Language: English
• Subjects: Age Factors; Behavior Therapy - methods; Behavioral therapy; Bladder volume wall index; Child; Child, Preschool; Cohort Studies; Egypt; Female; Follow-Up Studies; Humans; Male; Nocturnal enuresis; Nocturnal Enuresis - diagnostic imaging; Nocturnal Enuresis - physiopathology; Nocturnal Enuresis - therapy; Organ Size; Pediatrics; Predictive Value of Tests; Risk Assessment; Rural Population; Severity of Illness Index; Sex Factors; Socioeconomic Factors; Treatment Outcome; Ultrasonography; Urban Population; Urinary Bladder - anatomy & histology; Urinary Bladder - diagnostic imaging; Urodynamics; Urology
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2010.12.011

Abstract Objective To evaluate the role of bladder volume and bladder wall thickness measurement by ultrasound in assessing severity and predicting response to behavioral therapy in children with monosymptomatic nocturnal enuresis. Methods 122 children (68 boys and 54 girls) aged 5–9 years underwent ultrasound evaluation of bladder volume and bladder wall thickness, followed by calculation of the bladder volume wall thickness index (BVWI). They were treated using first-line management (behavioral therapy) for 4 months. Correlation of severity and treatment response to ultrasound bladder measurements was investigated. Results Only 74 children completed the study: 16 showed complete response to treatment, 25 good response, 18 partial response, and 15 children showed no response. Age, gender and location of residence did not correlate to severity or to treatment response. Ultrasound measured bladder volume also did not correlate to either severity or response. Bladder wall thickness showed a strong correlation to both severity and response to treatment, as did BVWI. Conclusion Ultrasound measured bladder wall thickness and BVWI are strongly associated with the severity of nocturnal enuresis and are highly predictive of treatment response to behavioral therapy. It is recommended that any child with monosymptomatic nocturnal enuresis should undergo an abdominal ultrasound examination before starting treatment.