The role of pelvic traction in the management of primary monosymptomatic nocturnal enuresis.
To determine whether pelvic traction is beneficial in children with primary nocturnal enuresis. There can be disproportionate growth between the spinal column and neural tube in prepubertal children. The normal elongation of the vertebral column in children during sleep could stretch the filum terminale and nerve roots, representing a minor degree of tethering that affects neural function and contributes to nocturnal enuresis. Pelvic traction induces a similar or more intense stretch while a patient is fully awake (and able to control their bladder). Releasing the potential tethering in this way, combined with conditioning therapy, could be beneficial. Fifty patients (aged 7-17 years) with monosymptomatic primary nocturnal enuresis were evaluated in a prospective study. All had 10 sessions of pelvic traction applied over 4 weeks and were followed up for 3 months afterward; no other medications were given. All patients had fewer wet nights, with variable degrees of success (20-80%) during and 3 months after traction. Pelvic traction is a safe, simple, economic and effective treatment for primary monosymptomatic nocturnal enuresis.