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Trial · Interventional

RecruitingNot applicableRegistry data

Effectiveness of Pelvic Floor Muscle Rehabilitation Combined With Desmopressin in Children With Primary Monosymptomatic Nocturnal Enuresis

NCTNCT06883851 (opens ClinicalTrials.gov in a new tab)Other idE-10840098-202.3.02-6971

This trial does not test a peptide that PepBank tracks.

  • Names Desmopressin, does not test it. It appears in the title.

Overview

Status
Recruiting
Phase
Not applicable
Enrollment
40 participants (estimated)
Sponsor
Bahçeşehir University · Other
Design
Randomized · Open label (no masking)
Countries
1 country

Turkey (Türkiye)

Start
11 Mar 2025
Primary completion
11 Mar 2027 (estimated)
Completion
30 Aug 2027 (estimated)
First posted
19 Mar 2025
Last update posted
19 Mar 2025
Conditions
Primary Nocturnal Enuresis · Nocturnal Enuresis in Children

Timeline

1 trial · 1 ongoing

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
2025202620272028
  1. N/A

    Effectiveness of Pelvic Floor Muscle Rehabilitation Combined With Desmopressin in Children With Primary Monosymptomatic Nocturnal Enuresis

    NCT06883851

    11 Mar 2025 to est. 30 Aug 2027

Registry summary

Text and fields below are the sponsor's entries at ClinicalTrials.gov, shown as posted.

The aim of this randomized controlled trial is to evaluate the effects of Structured Pelvic Floor Muscle Rehabilitation (SPFMR) in children with Primary Monosymptomatic Nocturnal Enuresis (PMNE) who are undergoing desmopressin asetat (DDAVP) treatment prescribed by a pediatric urologist. The study aims to investigate whether SPFMR can reduce the frequency and severity of enuresis episodes and whether it can also reduce relapse rates in the short- and long-term follow-up. The main questions the study seeks to answer are: * Does SPFMR reduce the frequency and severity of enuresis episodes in children with PMNE? * Does SPFMR treatment reduce relapse rates in children with PMNE in the long term? Researchers will compare the group receiving SPFMR in addition to DDAVP treatment with a control group receiving only DDAVP treatment. This comparison will help evaluate the effect of SPFMR on the severity of enuresis episodes and relapse rates. Participants will: * Receive DDAVP treatment (SPFMR group and Control group) * Participate in SPFMR sessions ( SPFMR group) * Keep a diary of enuresis frequency and severity * Assess relapse during short- and long-term follow-up The hypotheses of the study are: H0: Adding SPFMR to desmopressin treatment for children with PMNE has no short-term effect on the severity of enuresis episodes. H1: Adding SPFMR to desmopressin treatment for children with PMNE has a short-term effect on the severity of enuresis episodes. H0: Adding SPFMR to desmopressin treatment for children with PMNE has no long-term effect on the severity of enuresis episodes. H2: Adding SPFMR to desmopressin treatment for children with PMNE has a long-term effect on the severity of enuresis episodes.

Interventions

  • Structured pelvic floor rehabilitationOther

Arms2

  • No intervention

    Control Group (CG)

    The group that will receive first-line treatment, consisting of classic DDVAP treatment with evidence level A and urotherapy training, will be included in the treatment of PMNE. The DDVAP dosage will be determined and prescribed by the pediatric urologist. Only these treatments will be applied, and no pelvic floor rehabilitation will be implemented.

  • Experimental

    Structered Pelvic Floor Muscle Rehabilitation Group (SPFMRG)

    This group will receive, in addition to the DDVAP therapy prescribed by the pediatric urologist and urotherapy training, 10 weeks of structured pelvic floor muscle rehabilitation sessions.

Primary outcomes1

Outcomes the sponsor listed as primary.

  1. The Nighttime Bedwetting Diary

    Time frame · baseline; 10th week after baseline; 12th week after baseline and 16th week after baseline

    Registry description

    The diary records dry and wet nights, the amount of bedwetting, bedtime, and wake-up time. The nighttime bedwetting diary will be completed one week before treatment initiation, during the treatment period (10 weeks), and throughout the follow-up phase for both groups. Data will be shared weekly with the researchers, either face-to-face or via phone (WhatsApp, email, etc.).

Secondary outcomes(4)
  1. Uroflowmetry Test

    Time frame · baseline; 10th week after baseline; 12th week after baseline and 16th week after baseline

    Registry description

    During the uroflowmetry evaluation, patients will be asked to urinate into a sensor-equipped uroflowmetry container (MMES ® brand) when they feel the urge to urinate. For children whose feet do not touch the ground, a stool will be used to ensure a proper toilet position. To minimize external factors affecting the urination pattern, it will be ensured that no one else is present in the uroflowmetry room except the patient. The parameters obtained from the measurement will be used to evaluate the voiding phase of the bladder. Flow rate will be recorded. Flow rate is the volume of urine per unit of time, typically expressed in milliliters per second (ml/s).

  2. Post-Void Residual (PVR) Assessment

    Time frame · baseline; 10th week after baseline; 12th week after baseline and 16th week after baseline

    Registry description

    The Clarius® transabdominal ultrasound device will be used, and measurements will be performed from the suprapubic region. During the measurement, the patient will be positioned in a supine position with knees slightly flexed and supported with a towel beneath. The volume values calculated by the probe in the coronal and sagittal regions in mm³ will be automatically multiplied by the ultrasound system to calculate the residual urine volume in the bladder.

  3. Bladder Diary

    Time frame · baseline; 10th week after baseline; 12th week after baseline and 16th week after baseline

    Registry description

    The diary will be maintained over a 48-hour period, recording daytime voiding frequency, voided volume, fluid types, and the amounts.

  4. Pelvic Floor Muscle Activation Measurement

    Time frame · baseline; 10th week after baseline; 12th week after baseline and 16th week after baseline

    Registry description

    After proper placement of the electrodes, PFM activity will be measured using the NeuroTrac Myoplus4 Pro device. The CE certificate and registration of the device with the Ministry of Health are presented. Participants will be asked to perform 5 seconds of maximal contractions of their PFM ("work" phase EMG activity) followed by 5 seconds of relaxation ("rest" phase EMG activity), repeated in succession after resting. The device provides verbal commands of "work" for each contraction and "rest" for each relaxation. The measurement lasts for 55 seconds.

Posted results

Values are shown as posted at ClinicalTrials.gov, with their units. PepBank has not converted, pooled or compared them.

No results are posted for this trial.

A trial that is still running, or that stopped early, may post results later.

Registry data comes from ClinicalTrials.gov. Study results come from studies, not from the registry. How PepBank works

Studies1

Studies that cite this trial.

Studies with results

1 study on this page

Indexing hint: Clinical trial · 2000

3 results

Functional bladder capacity as predictor of response to desmopressin and retention control training in monosymptomatic nocturnal enuresis.

Hamano et al. 2000European urologycited by 30

PMID 10828674DOI 10.1159/000020224PUB-10828674

Full text at the publisher3 results

Other registry references

References listed at the registry that are not in PepBank. They link to PubMed.

  • ResultReilly M, Homsy Y. Treatment of a child with daytime urinary incontinence. Pediatr Phys Ther. 2008 Summer;20(2):185-93. doi: 10.1097/PEP.0b013e318171fb8d. PMID 18480719
  • ResultKim DH, An DH, Yoo WG. Effects of 4 weeks of dynamic neuromuscular stabilization training on balance and gait performance in an adolescent with spastic hemiparetic cerebral palsy. J Phys Ther Sci. 2017 Oct;29(10):1881-1882. doi: 10.1589/jpts.29.1881. Epub 2017 Oct 21. PMID 29184312
  • ResultBo K. Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work? Int Urogynecol J Pelvic Floor Dysfunct. 2004 Mar-Apr;15(2):76-84. doi: 10.1007/s00192-004-1125-0. Epub 2004 Jan 24. PMID 15014933
  • ResultLadi-Seyedian SS, Sharifi-Rad L, Nabavizadeh B, Kajbafzadeh AM. Traditional Biofeedback vs. Pelvic Floor Physical Therapy-Is One Clearly Superior? Curr Urol Rep. 2019 May 30;20(7):38. doi: 10.1007/s11934-019-0901-9. PMID 31147796
  • ResultWagner B, Steiner M, Huber DFX, Crevenna R. The effect of biofeedback interventions on pain, overall symptoms, quality of life and physiological parameters in patients with pelvic pain : A systematic review. Wien Klin Wochenschr. 2022 Jan;134(Suppl 1):11-48. doi: 10.1007/s00508-021-01827-w. Epub 2021 Mar 22. PMID 33751183
  • ResultHodges, P., R. Sapsford, and H. Pengel, Feedforward activity of the pelvic floor muscles precedes rapid upper limb movements. 2002.
  • ResultCampos RM, Lucio AC, Lopes MHBM, Hacad CR, Perissinotto MCR, Glazer HI, D'Ancona CAL. Pelvic floor muscle training alone or in combination with oxybutynin in treatment of nonmonosymptomatic enuresis. A randomized controlled trial with 2-year follow up. Einstein (Sao Paulo). 2019 Jun 27;17(3):eAO4602. doi: 10.31744/einstein_journal/2019AO4602. PMID 31271608
  • ResultMa Y, Liu X, Shen Y. Effect of traditional Chinese and Western medicine on nocturnal enuresis in children and indicators of treatment success: Randomized controlled trial. Pediatr Int. 2017 Nov;59(11):1183-1188. doi: 10.1111/ped.13417. PMID 28891253
  • ResultVesna ZD, Milica L, Stankovic I, Marina V, Andjelka S. The evaluation of combined standard urotherapy, abdominal and pelvic floor retraining in children with dysfunctional voiding. J Pediatr Urol. 2011 Jun;7(3):336-41. doi: 10.1016/j.jpurol.2011.02.028. Epub 2011 Apr 27. PMID 21527231
  • ResultShah, V., T. PalEkar, and P. GuruPraSad, Surface Electromyography of Perianal Muscles in Children with and without Enuresis: A Cross-sectional Study. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2022. 16(1): p. SC01-SC03.
  • ResultAbd El-Moghny, S.M., et al., Pelvic Floor Muscles Activity Deviation from the Normal among Children with Primary Monosymptomatic Nocturnal Enuresis. 2019.
  • ResultHaid B, Tekgul S. Primary and Secondary Enuresis: Pathophysiology, Diagnosis, and Treatment. Eur Urol Focus. 2017 Apr;3(2-3):198-206. doi: 10.1016/j.euf.2017.08.010. Epub 2017 Sep 6. PMID 28888814
  • ResultNeveus T. Pathogenesis of enuresis: Towards a new understanding. Int J Urol. 2017 Mar;24(3):174-182. doi: 10.1111/iju.13310. Epub 2017 Feb 16. PMID 28208214
  • ResultKawauchi A, Tanaka Y, Naito Y, Yamao Y, Ukimura O, Yoneda K, Mizutani Y, Miki T. Bladder capacity at the time of enuresis. Urology. 2003 May;61(5):1016-8. doi: 10.1016/s0090-4295(02)02515-3. PMID 12736027
  • ResultAustin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, Rittig S, Walle JV, von Gontard A, Wright A, Yang SS, Neveus T. 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. Neurourol Urodyn. 2016 Apr;35(4):471-81. doi: 10.1002/nau.22751. Epub 2015 Mar 14. PMID 25772695

Eligibility

Who could join, as posted.

Sex
All
Age
from 7 Years up to 13 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
Inclusion Criteria: * Being between 7 and 13 years old * Diagnosed with primary MNE by a pediatric urology department within the last 6 months * No urinary tract infection verified by laboratory tests * Ability to communicate in Turkish and absence of mental deficit * No diagnosed psychiatric problems * Willingness to participate in the study (child and family) Exclusion Criteria: * Presence of orthopedic conditions preventing evaluation * Anatomical anomalies in the urinary system * History of urinary system surgery * Neurological disorders * Presence of mental retardation * History of orthopedic surgery that could alter pelvic or lower extremity integrity * Receiving PFM rehabilitation in the last 6 months * Using nighttime alarm therapy in the last 6 months * Receiving any treatment for enuresis in the last 6 months

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