Commentary to: No effect of basic bladder advice in enuresis--A randomized controlled trial.
The authors of this study are to be congratulated on their efforts of trying to prove the value of the concept of simple bladder training advice (BBA) for treating treatment-naı̈ve nocturnal enuresis (NE). Their goal was to find out if previous BBA (e.g. provided in primary care settings) could be used as standalone therapy or to ameliorate the outcomes of bedwetting alarm treatment. Their conclusion was negative for both hypotheses. Some marginal notes may be given: First of all, the patient groups included those with monosymptomatic and nonmonosymptomatic NE, both without urinary incontinence. Indeed, this is the way in which children present to primary healthcare practitioners. However, the fact that the treatment outcome did not change for the mixed group when a very short period of BBA before alarm treatment was started does not prove that BBA wouldn’t help patients belonging to one of either subgroup. Prior to removing the concept of BBA from the standardization documents on NE, this requires further study. However, the authors do prove that 4 weeks of BBA is too short a time to change overall