ESPN 51th Annual Meeting

ESPN 2018

Is there a place for diet adjustment in standardurotherapy in enuresis
Valerie Van Bogaert 1 Nathalie Debruijn 1 Ann Raes 1 Nathalie Seegers 1 Lien Dossche 1 Agnieszka Prytula 1 Johan Vande Walle 1

2- safepedrug

 Urotherapy is the first step in treatment of nocturnal diuresis. Diet adjustment are presented as an element of urotherapy, although evidence on the possible effect of dietary adjustments in enuretic patient is limited in literature.In this investigation we want to examine the possible effect of diet adjustments with salt- and protein restriction on nighttime urine production and urinary osmolality in enuretic patients.

Material and methods:

A prospective study on a tertiary population of new enuretic patients aged 6 – 16 years. Using voiding diary’s before and after diet adjustments we have sought for an effect on nighttime urine production. Urinary samples before and after diet adjustments were performed to find a difference in urinary osmolality.



 28 patients were included, 12 girls and 16 boys with an average age of 8 years old. No patients dropped out. 50% of the patients suffered non monosymptomatic enuresis, 50% monosymptomatic enuresis. The majority of patients showed intermittent nocturnal polyuria following ICCS definition of 130% of estimated bladder capacity. After the diet adjustments a decrease in mean nighttime urine production was seen in the majority of patients. (figure 1)

A significant decrease in wet nights was observed after diet adjustment. A median decrease of 1 wet night, from 7/7 wet nights to 6/7 wet nights, was observed.

A median decrease of 1,5 wet nights on 7 nights with nocturnal polyuria according to the ICCS definition was observed. The result for urinary osmolality were very variable, no clear correlation could be made.


 Our results confirm the data we presented already  in a smaller population of enuretic patients: that there is a positive influence of salt- and protein restriction on nighttime urine production, number of wet nights and number of nights with nocturnal polyuria. The decrease in nocturnal dieresis was insufficient to reach complete dryness. The majority of patients suffered nocturnal polyuria, which can affect our study results. Further investigation is required to select suitable candidates for diet adjustments.