This is an original study that aims to investigate the feasibility and clinical significance of a 3-day voiding diary (VD) for assessing severe primary nocturnal enuresis (PNE) in children.

A multicenter prospective study was conducted on 141 children (aged 6–14 years) diagnosed with severe enuresis (≥4 nights/week) according to the International Children’s Continence Society (ICCS) criteria [1], from January to December 2023. Participants were divided into non-monosymptomatic enuresis (NMNE) and monosymptomatic enuresis (MNE) groups based on the presence or absence of daytime lower urinary tract symptoms [1]. Each child completed a 2-week VD, from which 3-day VD data (Friday, Saturday, and Sunday) were extracted. VD parameters between the 2-week and 3-day VD were compared.

A total of 128 children completed the 2-week VD (87 MNE, 41 NMNE). Among the 87 MNE patients, 51 were male and 36 were female, with a mean age of 9.20±2.193 years (range: 6-14 years) and a BMI of 16.91±2.384. The 41 NMNE patients included 21 males and 20 females, with a mean age of 9.95±2.674 years (range: 6-15 years) and a BMl of 16.97±1.879. No statistically significant differences were observed between the 2-week and 3-day VD in the following parameters: average daily voiding frequency, average voided volume/expected bladder capacity (EBC), average maximum voided volume, average maximum voided volume/EBC, average total nocturnal voided volume, and average total nocturnal voided volume/EBC (all P > 0.05). Positive correlations were found between the 3-day and 2-week VD data for average voided volume (AVV) in both MNE (r = 0.876, P < 0.05) and NMNE groups (r = 0.801, P < 0.05). The treatment plans based on VD results achieved satisfactory outcomes.

Nearly 10% of the patients included in this study did not complete the 2-week VD, indicating that the compliance of the 2-week VD still needs to be improved. The results showed that there was no statistical difference in the parameters of 3-day and 2-week VD in children with severe MNE and NMNE (P > 0.05). In the MNE and NMNE patient groups, the AVV recorded for 3-day and 2-week VD was positively correlated and had a strong correlation (P < 0.05). It is indicated that 3-day VD can completely replace 2-week VD to evaluate the condition of children with severe PNE.

A 3-day VD might replace the 2-week VD for evaluating both severe MNE and NMNE in children and guide personalized clinical management.

Austin PF, Bauer SB, Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children's Continence Society [J]. J Urol, 2014, 191(6): 1863-1865.e1813. DOI: 10.1016/j.juro.2014.01.110.