An exploration of outcome criteria in nocturnal enuresis treatmentThe way forward

Abstract

This paper is a review of outcome definitions and criteria for nocturnal enuresis treatment. A search of the literature published between 1991 and 2001 highlighted 97 papers. Although the International Children's Continence Society and the World Health Organization have published outcome criteria, different, often idiosyncratic, outcome criteria and/or definitions have been adopted in published research on treatment for nocturnal enuresis in recent years. There remains a debate as to what constitutes successful treatment and how to document improvement. Lack of an agreed definition of outcome reduces confidence in comparing studies, with serious clinical and research implications. This paper reviews aspects of importance in determining outcome, including a suggestion to focus on the establishment of dry nights rather than the reduction of wet nights. A new set of criteria is suggested, consisting of a banding system referred to as a "dryness scale", which focuses on the percentage of dry nights accomplished at a point in time, thus eliminating the need to compare current levels of dryness with a baseline.

Changes in parents' and self-reports of behavioral problems in Brazilian adolescents after behavioral treatment with urine alarm for nocturnal enuresis

“…Based on our data, we cannot answer the question about whether it is necessary to achieve success in enuresis treatment to have changes on other behavioral problems, since virtually all our participants achieved control over bedwetting (at least 14 dry nights). This study as not able to replicate the study performed in the Netherlands (18) that compared behavioral changes that occurred in the group that achieved success and the group that did not achieved success with the enuresis treatment because in our study all participants achieved at least two consecutive weeks with dry nights, the most widely used success criterion (14).…”

“…However, the the literature has reported different inclusion criteria and success criteria (13,14). If we considered 14 consecutive dry nights, the most widely used success criterion found in the literature (14), we would have achieved 100% success.…”

“…The criteria used to consider a child as being enuretic are usually different from one study to another, and the methodological design to be drawn (13,14). In addition, most studies focus on externalizing problems evaluated from only one point of view (parental evaluation of their children's behavior), thereby ignoring the internalizing problems and adolescents' self-reports.…”

The standardization of terminology of lower urinary tract function in children and adolescents: Report from the standardization committee of the International Children's Continence Society (ICCS)

“…The only aim of this document is to facilitate comparison between future studies. For more in-depth discussions of parameters of success and treatment outcome other texts can be consulted [Butler, 1991;Butler et al, 2004].…”

Evidências de validade do "Inventário de Autoavaliação para Adolescentes" (YSR/2001) para a população brasileira

“…Definições e classificações de psicopatologias são apontadas por diversos autores como um problema metodológico na comparação dos resultados encontrados em estudos (e.g. Mash & Dozois, 2003;Butler, Robinson, Holland, & Doherty-Williams, 2004;Belfer, 2008), visto que nem sempre o mesmo critério é adotado. Assim, métodos padronizados de avaliação dos problemas facilitam análises sistemáticas das semelhanças e diferenças entre culturas, e permitem uma melhor comunicação sobre o funcionamento global das crianças e adolescentes no mundo .…”