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Winter is associated with failure in the alarm treatment of nocturnal enuresis

By Y. Shiroyanagi, W. Kim, H. Suzuki, and Y. Yamazaki.

Journal of Pediatric Urology, Volume 10, Issue 2, April 2014, Pages 246-249

Editor's comments:
Winter is associated with a higher failure rate in the alarm treatment for nocturnal enuresisIn this retrospective study over one year, including four seasons, 67 children with nocturnal enuresis were treated with alarm.  The authors observed an average success rate of 55% for the entire year, with specifically 68% success in summer time and 38% in winter time.



To assess whether the winter season in Japan is associated with failure in the alarm treatment of nocturnal enuresis (NE).

Patients and methods
Consecutive patients with NE referred to our center between June 2009 and May 2010 were treated with the enuresis alarm (EA). The EA was used for 16 weeks with each child. Patients were divided into a success group and a treatment failure group. Pretreatment variables were collected, including age, sex, night-time urine volume, severity of enuresis, presence of nocturnal polyuria, presence of daytime incontinence, and treatment initiation season. These variables and initial success rates were retrospectively compared between the two groups. Chi-square, Student t tests, and multivariate regression analysis were used for statistical analysis.

A total of 67 children with NE were evaluated, 37 (55%) in the success group and 30 (45%) in the failure group. None of the pretreatment variables differed significantly between groups except for season; winter season initiation was an independent risk factor for failure in multivariate regression analysis.

Winter was associated with failure in the EA treatment. We recommend that EA be introduced in the summer season in Japan to achieve an optimal success rate.


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Consensus Guidelines

Practical consensus guidelines for the management of enuresis. 
Evaluation and management of enuresis, a common condition, is not a priority in training programs for medical doctors (MDs), despite being a common condition.