Changes in nocturnal bladder capacity during treatment with the bell and pad for monosymptomatic nocturnal enuresis.

Abstract

We examined changes in nocturnal urine production and bladder capacity in enuretic children during bell and pad treatment. A total of 18 children 7 to 11 years old with severe nocturnal enuresis had nocturnal urine production measured for a 14-day baseline period, which included daytime voidings on weekends. Thereafter, a 6-week treatment with the bell and pad was initiated, and nocturnal urine production and bladder capacity were monitored. Of 18 patients 10 became dry. Maximum daytime bladder capacities before treatment were fairly normal with no indication of treatment outcome. At the beginning of treatment maximum nocturnal bladder capacity was smaller than maximum daytime bladder capacity and during treatment it increased gradually. An increase in bladder volume during the enuretic episode was noted as well. No overall changes were found for nocturnal urine production. Treatment with the bell and pad is associated with a significant increase in nocturnal bladder capacity, in children who became dry and in those who remained wet. This increase explains why after attaining dryness the children were able to sleep through the night instead of having nocturia.