Abstract
Objectives To evaluate the effectiveness of rapid palatal expansion in the treatment of nocturnal enuresis among 6–18-year-old children and adolescents. Methods Comprehensive searches were carried out in 6 electronic databases (EBSCO, ProQuest, Clinical Key, Science Direct, SCOPUS, and OVID) and supplemented by additional manual searches in 4 orthodontic journals until June 2020. Randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) of children and adolescents aged 6–18 years old of both genders who underwent rapid palatal expansion and were considered unresponsive to previous conventional nocturnal enuresis treatment were included in this review. Risk of bias of individual trials was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) assessment tool for CCTs and the revised Cochrane Risk-of-Bias tool for RCTs (RoB 2). Results Four studies met all inclusion criteria and were finally included in this systematic review, of which one was an RCT and three were CCTs. Reduction in nocturnal enuresis frequency was reported in all included studies with varying rates and methods of reporting, but most studies reported a statistically significant reduction in the number of wet nights per week. The average range of becoming completely dry 1 year after treatment with an RME was 0%–60%. Also, there was a statistically significant correlation between an improvement in bedwetting and an increase in nasal volume after the use of RME. Conclusion A rapid palatal expansion device may be considered as an alternative treatment option of the nocturnal enuresis condition with guarded prognosis when other treatment modalities have failed.
Highlights
Nocturnal enuresis (NE) or bedwetting (BW) is a prevalent condition that affects around 10% of children around the world, making it the second most common problem in school aged children after asthma and allergies [1,2,3]
Following probing the full texts of these studies, 9 were excluded, of which 5 were case series, 1 was not in English, 2 included adult patients, and 1 was duplicate of another study. us, only four studies were included in this systematic review, of which one was a randomized clinical trial (RCT) and three were non-randomized clinical trials (CCTs)
Reduction in nocturnal enuresis was reported in all included studies with varying rates and methods of reporting such an improvement. ree studies [23, 24, 27] reported a reduction in NE frequency and presented their findings in terms of responders, intermediate responders, and non-responders
Summary
Nocturnal enuresis (NE) or bedwetting (BW) is a prevalent condition that affects around 10% of children around the world, making it the second most common problem in school aged children after asthma and allergies [1,2,3]. It is defined as the involuntary voiding of urine by distinct acts of micturition at night in children 5 years old and above and is more common in males than females [4]. It is important to distinguish between NE and nocturia which is defined as the frequent night awakening to void [8]
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