The role of pelvic traction in the management of primary monosymptomatic nocturnal enuresis.
Author: Mohamed EE.
Source:
BJU international, 89(4), 416-419.
OBJECTIVE: To determine whether pelvic traction is beneficial in children with
primary nocturnal enuresis. PATIENTS AND METHODS: There can be disproportionate
growth between the spinal column and neural tube in prepubertal children. The
normal elongation of the vertebral column in children during sleep could stretch
the filum terminale and nerve roots, representing a minor degree of tethering
that affects neural function and contributes to nocturnal enuresis. Pelvic
traction induces a similar or more intense stretch while a patient is fully awake
(and able to control their bladder). Releasing the potential tethering in this
way, combined with conditioning therapy, could be beneficial. Fifty patients
(aged 7-17 years) with monosymptomatic primary nocturnal enuresis were evaluated
in a prospective study. All had 10 sessions of pelvic traction applied over 4
weeks and were followed up for 3 months afterward; no other medications were
given. RESULTS: All patients had fewer wet nights, with variable degrees of
success (20-80%) during and 3 months after traction. CONCLUSION: Pelvic traction
is a safe, simple, economic and effective treatment for primary monosymptomatic
nocturnal enuresis.