{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:58:52Z","timestamp":1790913532983,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"vor","delay-in-days":276,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alarm therapy is the recommended first\u2010line treatment for nocturnal enuresis (NE). This study aimed to investigate the effectiveness of alarm monotherapy, identify predictors of treatment success, and examine factors contributing to self\u2010discontinuation in Japanese patients with NE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed the treatment course of 112 patients with NE who received alarm monotherapy between January 2017 and September 2024. The primary outcome was the predictors of treatment effectiveness, and the secondary outcome was factors contributing to self\u2010discontinuation of alarm therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 3\u2009months after initiating alarm monotherapy, treatment was effective in 49 patients (\u226550% reduction in NE), while 41 showed poor response (&lt;50% reduction in NE), 10 switched to pharmacotherapy, and 4 self\u2010discontinued alarm therapy. By 6\u2009months, only 9 of 41 patients who had shown poor response at 3\u2009months achieved an effective outcome, while 11 self\u2010discontinued alarm therapy. No factors predicting effectiveness were identified in the per\u2010protocol analyses. During the entire study period, 30 patients self\u2010discontinued alarm therapy, with 12 citing reluctance to wear the device. Refusal and self\u2010discontinuation rates were higher among patients with daytime urinary incontinence (DUI) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), developmental disabilities (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), no prior NE treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011), and ineffective treatment at 3 and 6\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001 and 0.045, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Alarm monotherapy can be recommended for any patient as no factors predicting effectiveness were identified. However, patients with no prior treatment, DUI, neurodevelopmental disorders, or ineffective alarm therapy may struggle to continue treatment with alarm monotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70204","type":"journal-article","created":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T07:18:57Z","timestamp":1759562337000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors influencing the efficacy and self\u2010discontinuation of alarm therapy for Japanese patients with nocturnal enuresis"],"prefix":"10.1111","volume":"67","author":[{"given":"Masaki","family":"Fuyama","sequence":"first","affiliation":[{"name":"Department of Pediatrics Showa Medical University, Fujigaoka Hospital  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0230-8933","authenticated-orcid":false,"given":"Hirokazu","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Children's Medical Center Showa Medical University Northern Yokohama Hospital  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuma","family":"Iwanaka","sequence":"additional","affiliation":[{"name":"Children's Medical Center Showa Medical University Northern Yokohama Hospital  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Ono","sequence":"additional","affiliation":[{"name":"Children's Medical Center Showa Medical University Northern Yokohama Hospital  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9473-5400","authenticated-orcid":false,"given":"Chisato","family":"Oyake","sequence":"additional","affiliation":[{"name":"Children's Medical Center Showa Medical University Northern Yokohama Hospital  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Endo","sequence":"additional","affiliation":[{"name":"Children's Medical Center Showa Medical University Northern Yokohama Hospital  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Onuki","sequence":"additional","affiliation":[{"name":"Children's Medical Center Showa Medical University Northern Yokohama Hospital  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3852-5219","authenticated-orcid":false,"given":"Yoshitaka","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Children's Medical Center Showa Medical University Northern Yokohama Hospital  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5389-4015","authenticated-orcid":false,"given":"Tsuneki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Children's Medical Center Showa Medical University Northern Yokohama Hospital  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2019.12.020"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(63)90003-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)63082-9"},{"key":"e_1_2_9_5_1","article-title":"Alarm interventions for nocturnal enuresis in children","volume":"5","author":"Caldwell PH","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2022.11.003"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.17039"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-017-3778-1"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2013.08.008"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2017.01.005"},{"key":"e_1_2_9_11_1","unstructured":"National Institute for Health and Care Excellence guidance.Bedwetting in children and young people overview 2020. [Cited 2023 December 10]. Available from:https:\/\/pathways.nice.org.uk\/pathways\/bedwettinginchildrenandyoungpeople"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2005.11.008"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000084669.59166.16"},{"issue":"645","key":"e_1_2_9_14_1","first-page":"e1","article-title":"Treating enuresis in children with neurodevelopmental disorders using bell and pad alarm","volume":"17","author":"Schuster S","year":"2021","journal-title":"J Pediatr Urol"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000004129"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41105-023-00473-1"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.4111\/icu.20240280"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2021-323488"},{"key":"e_1_2_9_19_1","first-page":"20","article-title":"Risk factors of nocturnal enuresis in children with attention deficit hyperactivity disorder","volume":"25","author":"Khazaie H","year":"2018","journal-title":"Shanghai Arch Psychiatry"}],"container-title":["Pediatrics International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70204","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ped.70204","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70204","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:44:08Z","timestamp":1790912648000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ped.70204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/ped.70204"],"URL":"https:\/\/doi.org\/10.1111\/ped.70204","archive":["Portico"],"relation":{},"ISSN":["1328-8067","1442-200X"],"issn-type":[{"value":"1328-8067","type":"print"},{"value":"1442-200X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70204"}}