Foot Neuromodulation for Nocturnal Enuresis

Nocturnal Enuresis is a very common and difficult to treat problem in the pediatric population which can have significant negative impact on a child's quality of life. Apart from medications which can have significant side effects limiting their use, there is a lack of effective and safe treatment options for children with frequent nocturnal enuresis. If foot stimulation prior to bed does indeed improve the frequency of nocturnal enuresis, it may provide a safe and non-invasive therapeutic option.

Inclusion criteria

• Children ages 5 to 16 years old without any specific neurological disorder or urinary tract infection, clinically diagnosed as having nocturnal enuresis AT LEAST 4 episodes per month by history
• Currently having no daytime overactive bladder symptoms, i.e. urinary frequency, urgency, or daytime incontinence
• Having been assessed for and treated if applicable for behavioral etiologies of nocturnal enuresis - consuming excess fluids or specific bladder irritants
• Having been assessed for and treated if applicable for constipation

Exclusion criteria

• Children with known neurological disorders which may be contributing to nocturnal enuresis episodes
• Children found through history to have significant behavioral causes of nocturnal enuresis including consumption of excessive fluids or known bladder irritants
• Children with chronic constipation who are non-compliant with previous pharmacologic efforts to treat.
• Children who are not adequately potty trained
• Children with significant daytime symptoms of overactive bladder including frequency, urgency, and daytime incontinence

• Children who do not tolerate initial stimulation training session in the urology clinic upon enrollment

• Children with any implantable medical devices such as a pacemaker will be excluded from the study

Note: Any patient currently taking medication such as an anti-muscarinic or a tricyclic antidepressant for overactive bladder at time of enrollment will be eligible to participate and will be continued on their usual medication and dosage throughout the study.