Commentary on “No effect of basic bladder advice in enuresis: A randomized controlled trial”

Abstract

Cederblad et al. [1] are the first to report results of a randomized clinical trial (RCT) assessing whether the recommendation to initially treat all children suffering from nocturnal enuresis (NE) with basic bladder advice (BBA) can be supported by evidence. Forty children aged 6 years and older with primary untreated NE and without daytime incontinence were randomized to receive either first BBA during 1 month and then alarm therapy (AT) for 8 weeks, or only AT. Since BBA did not reduce enuresis frequency or the end results after the AT, the authors concluded that the recommendation to treat all children with BBA first cannot be supported and recommend to start with the AT or desmopressin as first-line treatment [1]. The research question was relevant and interesting. However, we feel that the conclusion cannot be supported because of important methodological flaws.