Immunoterapia orale per arachide, da piccoli è meglio. I risultati di un RCT

Abstract

Monosymptomatic primary nocturnal enuresis and daily urotherapy: an unnecessary intervention? Although evidence of their effectiveness is lacking, basic bladder function indications (urotherapy, BBA), according to old international guidelines have been the first step in treating nocturnal enuresis in children. Sixty-two children aged 6-11 were randomized into 3 groups (standard urotherapy, enuresis alarm, no treatment) and followed for 8 weeks; response to therapy was measured, defined as a reduction in the number of wet nights during the last 2 weeks of treatment (or no treatment), compared with 2 weeks before the intervention. The difference in reduction in frequency of enuresis between groups was highly significant (p=0.002) in favor of the alarm group, while no difference was found between BBA and controls. The small number of participants, the brevity of follow-up, and the lack of follow-up on compliance, do not allow the results to be generalized. It is reported that urotherapy is no longer planned in the treatment of monosymptomatic nocturnal enuresis according to the 2020 ICCS guideline update. Surprisingly, although the authors cited this update regarding the usefulness of the micturition chart in the initial evaluation of all children with enuresis, they made no mention of urotherapy being surpassed as the first level of treatment in monosymptomatic nocturnal enuresis.