Marzuillo P, et al. - This study entailed an elucidation of a cohort of children affected by extraordinary daytime only urinary frequency (EDOUF) for assessing its rate among the main micturition pediatric disturbances, and for ascertaining the presence of a different EDOUF onset among seasons. Experts also analyzed the possible correlations with urodynamic abnormalities by non-invasive techniques and determined if postponing micturition exercise (PME) verified the anamnestic data for EDOUF diagnosis. Furthermore, they gauged the impact of postponing micturition at home. It was reported that childhood EDOUF was a common occurrence that associated with normal non-invasive urodynamic patterns. Data illustrated that PME permitted verification of anamnestic data of EDOUF. The possible approach suggested herein was to postpone micturition for a maximum of 3 h or until the micturition postponement would become stressful.

Methods

• An appraisal was conducted of the records of all patients with EDOUF, nocturnal enuresis, and/or overactive bladder firstly examined from March 2012 to February 2016.
• This was followed by an analysis of the post-void residual and bladder wall thickness via urinary ultrasound and uroflowmetry along with recording of the season in which the EDOUF started.
• EDOUF diagnosis was confirmed via PME, if patients were able to postpone micturition reaching at least 80% of the expected bladder capacity without showing urinary incontinence.
• At home, postponing micturition for a maximum of 3 h was suggested if EDOUF exerted an impact on the normal daily activities of both children and parents.
• A telephone interview was set for 3 months later.

Results

• Clinical characteristics of 106 candidates with EDOUF was as follows: Age at EDOUF diagnosis, yr 6.8 ± 2.3; female sex, no. (%) 53 (50); systolic blood pressure (SBP), standard deviation score (SDS) 0.31 ± 0.7; diastolic blood pressure (DBP), SDS 0.17 ± 0.8; age at continence, yr 2.3 ± 0.5; nocturia, no. (%) 1 (0.9); constipation, no. (%) 19 (17.4); urgency, no. (%) 0 (0); incontinence, no. (%) 0 (0); expected bladder capacity (EBC) >80% at PME, no. (%) 106 (100); post-micturition bladder wall thickness >5 mm, no. (%) 1 (0.9); presence of post-void residual, no. (%) 1 (0.9); maximum flow, mL/s 19.34 ± 10.2; normal uroflowmetry, no. (%) 106 (100); normal urinalysis, no. (%) 106 (100); previous urinary tract infections (UTIs), % 2 (1.9); daily micturitions, no. 20.1 ± 7.2; mean daily voided volumes (% of the EBC) 28.7 ± 9.2.
• It was determined that only one patient presented a post-void residual of 30 mL.
• All the UTIs did not appear to be febrile.
• The EDOUF rate was found to be 12.1%.
• A substantially lower rate of EDOUF onset was noted during the summer compared to other seasons (p=0.02) and the OR for onset of EDOUF in the summer vs other seasons was 0.37 (95% CI 0.18-0.74; p=0.005).
• An intermittent trend of the EDOUF was revealed in 85 (80.2%) subjects, with variable periods of improvement and worsening.
• Normal uroflowmetry was found in all the EDOUF patients, 1/106 had post-micturition bladder wall thickness >5 mm and one post-void residual.
• At the PME, 106 candidates out of 106 (100%) patients with EDOUF attained at least 80% of the EBC without showing urinary incontinence or urgency incontinence.
• Symptoms disappeared or improved in 98.1% of the patients after 3 months.