{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T10:52:42Z","timestamp":1768215162046,"version":"3.49.0"},"reference-count":20,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Introduction: Nocturnal enuresis is defined as involuntary urination during sleep in children, particularly those aged 5 years or older. Primary monosymptomatic nocturnal enuresis (PMNE) involves nighttime wetting without daytime symptoms, and although factors like reduced bladder capacity, nocturnal polyuria, and impaired arousal contribute, predictors of long-term relapse remain uncertain. Methods: This retrospective cohort study included 227 children aged \u22655 years with strictly defined PMNE who achieved complete remission following a standardized 3-month treatment protocol (alarm therapy, desmopressin, or desmopressin plus oxybutynin). All children underwent ICCS-based assessment, including physical examination, urinalysis, ultrasonography, UFM, a 48 h frequency\/volume (F\/V) diary, and post-void residual measurement. One year after treatment discontinuation, patients were reassessed using a 14-day wet-night diary. Predictors of relapse were analyzed using comparative statistics. Result: At 1-year follow-up, 48.5% of children experienced relapse. Age, sex, treatment modality, family history, and baseline wet-night frequency were not associated with relapse (p &gt; 0.05). Diary-based FBC was significantly higher than UFM-based capacity (p &lt; 0.001). Reduced diary-based mean FBC\/EBC ratios were significantly more common among relapsing children (p &lt; 0.001), whereas UFM-derived ratios showed no significant difference (p = 0.052). ROC analysis demonstrated moderate discriminatory performance for diary-based FBC\/EBC (AUC 0.671). A ratio &gt; 79% predicted sustained remission with 83.6% specificity and a positive predictive value of 73.5%. Conclusions: Diary-derived bladder capacity is the strongest predictor of long-term relapse in PMNE and outperforms UFM-based assessment. A mean FBC\/EBC ratio &gt; 79% provides a clinically useful threshold for identifying children at low risk of recurrence. Those with reduced diary-based capacity may benefit from closer follow-up or extended maintenance therapy.<\/jats:p>","DOI":"10.3390\/children13010103","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T07:30:34Z","timestamp":1768203034000},"page":"103","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of Long-Term Relapse in Primary Monosymptomatic Nocturnal Enuresis: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Serap","family":"Ata","sequence":"first","affiliation":[{"name":"Department of Pediatrics, \u00dcmraniye Training and Research Hospital, University of Health Sciences, 34764 \u00dcmraniye, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7327-8228","authenticated-orcid":false,"given":"Sevim","family":"Yener","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, \u00dcmraniye Training and Research Hospital, University of Health Sciences, 34764 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/S0022-5347(06)00305-3","article-title":"The standardization of terminology of lower urinary tract function in children and adolescents: Report from the Standardisation Committee of the International Children\u2019s Continence Society","volume":"176","author":"Hoebeke","year":"2006","journal-title":"J. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jpurol.2019.12.020","article-title":"Management and treatment of nocturnal enuresis\u2014An updated standardization document from the International Children\u2019s Continence Society","volume":"16","author":"Fonseca","year":"2020","journal-title":"J. Pediatr. Urol."},{"key":"ref_3","first-page":"42","article-title":"Traditional and innovative interventions in the management of enuresis","volume":"77","author":"Ferrara","year":"2024","journal-title":"Cent. Eur. J. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"16755","DOI":"10.1038\/s41598-018-34935-1","article-title":"Systematic review and meta-analysis of alarm versus desmopressin therapy for pediatric monosymptomatic enuresis","volume":"8","author":"Peng","year":"2018","journal-title":"Sci. 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