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The study employs a multicenter, parallel, randomized controlled trial. Following a 4-week run-in period, participants were randomly allocated in a 2:1 group allocation to discontinue or continue using APP. The research was conducted across seven European pediatric incontinence centers. The study included treatment-na\u00efve children aged 4\u20138\u00a0years with severe (7\/7 wet nights per week) mono-symptomatic NE, who had used nighttime protection for at least 6\u00a0months prior to the study. The study consisted of a 4-week run-in period (\u00b1\u20097\u00a0days), where all children slept wearing APP (DryNites<jats:sup>\u00ae<\/jats:sup>). At week 4 (\u00b1\u20097\u00a0days), if meeting randomization criteria (7\/7 wet nights during the last week of run-in), participants were randomized to continue to sleep in APP or to discontinue their use for a further 4\u00a0weeks, with the option of another 4\u00a0weeks in the extension period. The primary outcome was the difference between groups of wet nights during the last week of intervention. Quality of life (QoL) and sleep were secondary endpoints. In total, 105 children (43 girls and 62 boys, mean age 5.6\u00a0years [SD 1.13]) were randomized (no-pants group <jats:italic>n<\/jats:italic>\u2009=\u200970, pants group <jats:italic>n<\/jats:italic>\u2009=\u200935). Fifteen children (21%) in the no-pants group discontinued early due to stress related to the intervention. Children in the no-pants group experienced fewer wet nights compared to the pants group during the last week (difference 2.3 nights, 95% CI 1.54\u20133.08; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). In the no-pants group, 20% responded to the intervention, of whom 13% had a full response. Clinical improvement was detected within 2\u00a0weeks. Sleep and QoL were reported as negatively affected by APP discontinuation in the extension period but not in the core period.<\/jats:p><jats:p><jats:italic>\u00a0 \u00a0 Conclusion<\/jats:italic>:\u00a0A\u2009~\u200910% complete resolution rate was associated with discontinuing APP. While statistically significant, the clinical relevance is debatable, and the intervention should be tried only if the family is motivated. Response was detectable within 2\u00a0weeks. Discontinuing APP for 4\u20138\u00a0weeks was reported to negatively affect QoL and sleep quality. No severe side effects were seen.<\/jats:p><jats:p><jats:italic>Trial registration<\/jats:italic>: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/\">Clinicaltrials.gov<\/jats:ext-link> Identifier: NCT04620356; date registered: September 23, 2020. Registered under the name: \u201cEffect of Use of DryNites Absorbent Pyjama Pants on the Rate of Spontaneous Resolution of Paediatric Nocturnal Enuresis (NE).\u201d<\/jats:p><jats:p><jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is Known?<\/jats:bold><jats:italic>\u2022 APP has been hypothesized to delay time until spontaneous resolution of bedwetting, but no prospective randomized evidence is available regarding if APP use sustains symptoms.<\/jats:italic><jats:italic>\u2022 No evidence whether discontinuation of APP can lead to dryness or impact sleep quality and QoL.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is New?<\/jats:bold><jats:italic>\u2022 Thirteen percent became dry after removing APP for up to 8\u00a0weeks\u00a0and\u00a0initial response was detectable within 2\u00a0weeks.<\/jats:italic><jats:italic>\u2022 Even though\u00a0 prolonged discontinuation was reported to lead to sleep disturbances and rediced QoL, still our results suggest trying 2\u00a0weeks of the intervention if the family is motivated, prior to engaging established treatments for nocturnal enuresis.\n<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-024-05502-w","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T22:01:51Z","timestamp":1710280911000},"page":"2443-2453","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Discontinuing absorbent pants in children with bedwetting: a randomized controlled trial"],"prefix":"10.1007","volume":"183","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8408-4381","authenticated-orcid":false,"given":"Anders","family":"Breinbjerg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0104-4884","authenticated-orcid":false,"given":"Konstantinos","family":"Kamperis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5541-7802","authenticated-orcid":false,"given":"Kristina","family":"Thorsteinsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3630-2329","authenticated-orcid":false,"given":"Cecilie Siggaard","family":"J\u00f8rgensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1030-9848","authenticated-orcid":false,"given":"Lien","family":"Dossche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4560-7485","authenticated-orcid":false,"given":"Juliette","family":"Rayner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1796-9452","authenticated-orcid":false,"given":"Jin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debora Garcia","family":"Rodrigues","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1054-0601","authenticated-orcid":false,"given":"Luise","family":"Borch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1217-808X","authenticated-orcid":false,"given":"S\u00f8ren","family":"Hagstr\u00f8m","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3708-459X","authenticated-orcid":false,"given":"Serdar","family":"Tekg\u00fcl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9700-5358","authenticated-orcid":false,"given":"Johan Vande","family":"Walle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00f8ren","family":"Rittig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,12]]},"reference":[{"key":"5502_CR1","doi-asserted-by":"publisher","first-page":"2303","DOI":"10.1016\/j.juro.2011.02.040","volume":"185","author":"A von Gontard","year":"2011","unstructured":"von Gontard A, Heron J, Joinson C (2011) Family history of nocturnal enuresis and urinary incontinence: results from a large epidemiological study. 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Furthermore, Anders Breinbjerg has consulted for Kimberly-Clark Corporation in regards with this study, receiving a research grant. Konstantinos Kamperis has consulted for Kimberly-Clark Corporation and has lectured for Ferring Pharmaceuticals and Novo Nordisk. Debora Garcia Rodrigues and Jin Zhang are employees of Kimberly-Clark Corporation.  S\u00f8ren Rittig has consulted for Kimberly-Clark Corporation.  The rest of the authors have nothing to disclose.  Study results has been presented as a poster during the ACA conference 2023, Birmingham, UK, and the study is scheduled for oral presentation at the 2023 ICCS conference, Salvador, Brazil.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}