Association between Rapid Maxillary Expansion and Nocturnal Enuresis in Children: A Pilot Study for a Randomized Controlled Clinical Trial

Xiaowen Niu,Marie A Cornelis,Paolo M Cattaneo,Konstantinos Kamperis

doi:10.3390/app10249025

Xiaowen Niu, Marie A Cornelis + Show 2 more

Open Access

https://doi.org/10.3390/app10249025

Copy DOI

Abstract

Objectives: This pilot study was conducted to test the protocol of a randomized controlled trial evaluating whether rapid maxillary expansion (RME) can relieve nocturnal enuresis (NE) and improve breathing in children, after ruling out a placebo effect, and investigating whether the effects of RME and NE are related to the morphology of the upper airway. Methods: Seventy 6–15-year-old patients with NE were assessed for eligibility (e.g., constricted maxilla). Enrolled subjects were randomized to immediate treatment with RME (Group 1) or to have the same treatment (RME) delayed for at least six weeks (Group 2). Outcomes comprised the number of wet nights per week, the nocturnal urine production, and the scores of a pediatric sleep questionnaire at baseline, after active treatment (Group 1) or delayed treatment (Group 2), and after 3 months’ retention. Cone beam computed tomographies were taken at baseline and after retention. Results: Six patients were randomized: three in each group. In four of six patients, the number of wet nights per week decreased. Moreover, in responders, nocturnal urine production was reduced following RME. Conclusions: This pilot study suggested that RME might reduce the severity of NE and showed that the protocol of this randomized controlled clinical trial was appropriate.

Highlights

Nocturnal enuresis (NE) is the involuntary loss of urine during sleep
Of the 70 subjects who were screened for inclusion, 53 did not meet the inclusion criteria and 11
70 subjects who wereGroup screened for boys; inclusion, 532,did notpatients meet the inclusion criteria and 11

Summary

Introduction

Nocturnal enuresis (NE) is the involuntary loss of urine during sleep. The condition affects7% to 10% of all 7-year-olds and 0.5% to 2% of young adults [1,2,3]. Nocturnal enuresis (NE) is the involuntary loss of urine during sleep. NE is a multifactorial disease, characterized by the production of an excessive amount of urine at night, termed nocturnal polyuria (NP), and it is the cause of bedwetting in a large number of children [4,5]. The treatment options for NE are commonly directed against the pathogenesis of the condition: the first-line treatment recommended by the International Children’s Continence Society comprises desmopressin, a synthetic analogue of an antidiuretic hormone, or the enuresis conditional alarm [4]. In the last few years, increasing evidence suggests sleep-disordered breathing (SDB) as one of the underlying etiologies of NE [8,9,10,11]. Treatment of SDB by adenotonsillectomy, respiratory support, or orthodontic treatment seems to lead to the amelioration or cure of bedwetting [12,13].

Objectives

Methods

Results

Discussion

Conclusion