Nocturnal enuresis: application of evidence-based medicine in community practice.
OBJECTIVE
To report the outcomes and follow-up at 2 years of children with monosymptomatic nocturnal enuresis (MNE) managed in a private paediatric community practice utilising body-worn alarms and supportive programmes.


METHODS
522 consecutive children presenting with MNE were assessed and managed with a comprehensive supportive programme and body-worn alarm. Data were recorded prospectively and outcomes assessed at 6 and 24 months.


RESULTS
505 proceeded with management. A total of 79.0% achieved initial dryness within a median of 10 weeks. Of those achieving initial dryness 73.0% had remained dry at 6-month follow-up and 64% had remained dry at 24 months. A total of 99.2% follow-up was achieved. Nineteen per cent of children required more than 16 weeks management with 56% achieving dryness. More girls achieved dryness than boys and in a shorter time. There was no gender difference in relapse rates at 6 and 24 months. No difference in achieving initial success was found with respect to initial severity of wetting, nor age. Relapse rates were unrelated to gender, age, or initial severity.


CONCLUSIONS
MNE can be successfully managed using body-worn alarms achieving good initial and long-term complete dryness, without the need for expensive pharmacologic intervention. A strong supportive programme can make the management less arduous for child and family.
Cutting
David A
DA
Paediatric Practice, Lilydale, Australia. dac@cambridgekids.com.au
Pallant
Julie F
JF
Cutting
Felicity M
FM
D050034:Antidiuretic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D053206:Nocturnal Enuresis / Q000517:prevention & control / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010372:Pediatrics; D011446:Prospective Studies; D014739:Victoria
D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin