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Daytime urotherapy in nocturnal enuresis: a randomised, controlled trial
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  • Published on:
    Short-term daytime urotherapy is likely to be ineffective in nocturnal enuresis treatment and it should be considered complementary to other therapeutic choices
    • Elia Balestra, Pediatric Resident University of Trieste, Trieste, Italy
    • Other Contributors:
      • Lara Colussi, Pediatric Resident
      • Marco Pennesi, Pediatric Nephrologist

    Dear editor, we read with interest the randomised controlled trial by Borgström et al.1 showing the lack of effectiveness of daytime urotherapy as first-line treatment of nocturnal enuresis. While the study has the remarkable point of strength of a prospective trial with a control, we take exception with some of the authors’ statements, and believe that some limits should be acknowledged.

    Reduction of enuresis frequency was evaluated after 7 and 8 weeks since the beginning of the study while previous studies showed effectiveness for longer treatments, lasting four months, with a 60% success rate2. While the authors acknowledge this difference they simply state that a longer duration would disqualify the therapy as a first-line choice anyway, increasing the risks of drop out. We believe that this is, as the author state in the discussion, simply their view, which is not based on any evidence. The length of a treatment should not necessarily rule out it as a first line option, especially when weighted against the costs of other options, specifically unpleasantness of the alarm and possible adverse effects of desmopressin. As a matter of fact, it could be speculated that 8 weeks are a too short period in a physiological perspective to develop different voiding patterns after years of an enuretic bladder function.

    Moreover, patients’ follow-up consisted only in contact by phone after 2 and 6 weeks, without clinical examination, and this could have contributed t...

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    Conflict of Interest:
    None declared.