Younger, Lighter, Drier: The Impact of Age and Body Mass Index on Treatment Success in Pediatric Monosymptomatic Nocturnal Enuresis

Objectives: To evaluate the effects of age, body mass index, and treatment duration on treatment response in children with primary monosymptomatic nocturnal enuresis and to determine the contribution of these variables to clinical outcomes. Methods: Data from 560 pediatric patients treated with desmopressin due to primary monosymptomatic nocturnal enuresis were retrospectively analyzed. Patient demographics, body mass index classifications, early treatment response, and dryness rates at 3 and 6 months were evaluated. Categorical variables were analyzed using the chi-square or Fisher’s exact test, and continuous variables were evaluated using Spearman correlation analysis. Significant factors predicting treatment success were investigated using multivariable analyses. Results: Treatment success was significantly higher in younger age groups, with increased early response rates and shorter treatment duration (p < 0.001). Higher body mass index was associated with a delay in early treatment response and the need for longer treatment (p < 0.0001). While the likelihood of treatment success decreased with increasing age, higher body mass index demonstrated a modest positive association with treatment response after multivariable adjustment. Conclusions: The findings indicate that age and body mass index are important determinants of treatment response in pediatric monosymptomatic nocturnal enuresis. These results suggest that treatment strategies should be individualized by considering both age and body mass index.