Use of an enuresis alarm to guide timing of post-void residual volume assessment in infants and medically-complex, non-verbal children.

Abstract

Objectives: To test the feasibility and efficacy of using an enuresis alarm to guide timing of post-void residual (PVR) measurement in two different cohorts of non-verbal, non-toilet trained pediatric patients.

Methods: We prospectively enrolled 15 infants (Group 1) and 15 medically-complex patients (Group 2) to undergo an 8-hour study period that included a 4-hour intervention period with alarm (PVR after alarm trigger) and a 4-hour control period of routine care (PVR when nurses observe wet diapers). The primary endpoint of PVR volume was analyzed using linear regression with volume as the dependent variable and both study period and patient weight as independent variables. Secondary endpoint of the number of detected voids was analyzed using Mann-Whitney U test.

Results: In Group 1, median number of voids detected was significantly greater in the alarm versus routine care periods (3 vs 2, p=0.0029). Use of alarm was associated with a non-significant mean decrease of 2.23 mL (95% CI -7.09 to 2.63, p=0.363) in PVR volume for infants. In Group 2, median number of detected voids were also significantly different in the alarm versus routine care periods (3 vs 1, p=0.0312). Use of alarm was associated with a mean decrease of 21.09 mL (95% CI -40.60 to -1.58, p=0.035) in PVR volume.

Conclusions: An enuresis alarm facilitated detecting significantly more voids in both infants and medically-complex, non-verbal children and was also associated with a decrease in PVR volume in the latter group. Such use of enuresis alarms may prove useful to measure PVR more accurately in these challenging populations.