Objective To evaluate the response rate of various modalities of therapy in primary nocturnal enuretic children according to ultrasound BVWI (bladder volume and wall thickness index) measurements.

Methods From February 2006 to November 2007 a total of 31 children aged 6 to 12 years old were enrolled in a clinical trial. Based on BVWI they were divided into 3 groups as follows: Ten children in group 1 (BVWI<70%) who were treated with oral desmopressin and oxybutynin. Sixteen children in group 2 (70%<BVWI<130%) were treated with oral desmopressin. Five children in group 3 (BVWI>130%) were treated with oral desmopressin accompanied by double-voiding technique and schedule voiding. All of them were treated for three months.

Results Significant reductions in mean bed-wetting frequency before and after first treatment cycle were observed in all groups (p<0.05).The complete response rate was 70%, 25% and 20% in group 1, group 2 and group 3, respectively. Overall the complete and partial response rate was 9 of 10 children in group 1 (90%), 13 of 16 in group 2 (81%), and 3 of 5 in group 3 (60%). Bedwetting frequency significantly decreased at the first and second treatment cycles in group 2 (p<0.05 for each pair wise comparison).

Conclusion The proposed treatment representation according to ultrasound measurements of bladder wall thickness achieves favorable response rates in the treatment of children with primary nocturnal enuresis. We suggest that this treatment should be used to develop the management of enuresis in children.