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KMID : 1011820230640050501
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Investigative and Clinical Urology
2023 Volume.64 No. 5 p.501 ~ p.509
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First-morning urine osmolality and nocturnal enuresis in children: A single-center prospective cohort study
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Lee Gwon-Kyeong
Chung Jae-Min
Lee Sang-Don
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Abstract
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Purpose : To investigate the treatment outcome of nocturnal enuresis (NE) according to first-morning urine osmolality (Uosm) before treatment.
Materials and Methods : Ninety-nine children (mean age, 7.2±2.1 y) with NE were enrolled in this retrospective study and divided into two groups according to first-morning Uosm results, that is, into a low Uosm group (<800 mOsm/L; 38 cases, 38.4%) or a high Uosm group (≥800 mOsm/L; 61 cases, 61.6%). Baseline parameters were obtained from frequency volume charts of at least 2 days, uroflowmetry, post-void residual volume, and a questionnaire for the presence of frequency, urgency, and urinary incontinence. Standard urotherapy and pharmacological treatment were administered initially in all cases. Enuresis frequency and response rates were analyzed at around 1 month and 3 months after treatment initiation.
Results : The level of first-morning Uosm was 997.1±119.6 mOsm/L in high Uosm group and 600.9±155.9 mOsm/L in low Uosm group (p<0.001), and first-morning voided volume (p=0.021) and total voided volume (p=0.019) were significantly greater in the low Uosm group. Furthermore, a significantly higher percentage of children in the low Uosm group had a response rate of ≥50% (CR or PR) at 1 month (50.0% vs. 24.6%; p=0.010) and 3 months (63.2% vs. 36.1%; p=0.009).
Conclusions : Treatment response rates are higher for children with NE with a lower first-morning Uosm.
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KEYWORD
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Child, Nocturnal enuresis, Osmolar concentration, Urinalysis, Urinary bladder
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