Functional bladder capacity after bladder biofeedback predicts long-term outcome in children with nocturnal enuresis.
OBJECTIVE
We previously reported a 70% cure rate for bladder biofeedback in children with primary nocturnal enuresis associated with small bladder capacity and detrusor instability. In this paper we report on bladder capacity and incidence of enuresis after 60 months of follow-up and discuss the role of decreased bladder capacity in nocturnal enuresis.


METHODS
We prospectively evaluated 21 boys and 3 girls (mean age 10.4 years) treated with bladder biofeedback between October 1993 and July 1995. Baseline bladder capacity and capacity at the end of treatment and at 60 months follow-up were determined from a micturition chart.


RESULTS
At the end of primary treatment 17/24 patients had stopped bedwetting. In 4/17 responders and 4/7 non-responders the bladder capacity was <90% of normal for age. At 60 months, 4 patients had been lost to follow-up, 15 were dry at night and 4 continued bedwetting. One patient underwent surgery and was excluded from the study. Only 2/15 dry patients but 3/4 patients with persistent nocturnal enuresis had a bladder capacity of <90% of normal.


CONCLUSIONS
Bladder biofeedback can be successfully used to treat children with refractory nocturnal enuresis associated with small bladder capacity and unstable detrusor. Normalization of bladder capacity and continuous growth of the bladder in order to keep the capacity normal would seem to be crucial to the long-term resolution of bedwetting in this select patient population.
Department of Urology, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium.
Lucien
L
Hoekx
Alexandra
A
Vermandel
Jean-Jacques
JJ
Wyndaele
D001676:Biofeedback, Psychology; D002648:Child; D004775:Enuresis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000033:anatomy & histology; D001745:Urinary Bladder Diseases / Q000150:complications / Q000628:therapy*; D014563:Urodynamics / Q000502:physiology