The impact of screen exposure on symptom severity and desmopressin treatment outcomes in primary monosymptomatic nocturnal enuresis

Purpose: This study aimed to investigate the relationship between daily screen exposure duration, symptom severity, and desmopressin treatment success in children with primary monosymptomatic nocturnal enuresis.Materials and methods: A retrospective cohort study was conducted on children aged five years and older diagnosed with primary monosymptomatic nocturnal enuresis between January 2020 and January 2026. Patients were categorized into three groups based on daily screen exposure: 0-1 hour (n=141), 1-2 hours (n=139), and more than 2 hours (n=190). Symptom severity was classified as mild, moderate, or severe based on weekly wet nights. Treatment response to oral desmopressin lyophilisate was evaluated after three months and categorized as complete, partial, or no response.Results: Higher screen exposure was significantly associated with increased symptom severity (p<0.001). In the group with more than 2 hours of exposure, 74.7% of patients had severe symptoms, compared to 39.0% in the 0-1 hour group. Regarding treatment outcomes, desmopressin efficacy decreased as screen time increased (p<0.001). The complete response rate was 36.8% in the 0-1 hour group and 34.8% in the 1-2 hour group but dropped to 20.6% in the group with more than 2 hours of screen exposure. Furthermore, the no-response rate was highest in the group for more than 2 hours at 46.3%.Conclusion: In this study, higher levels of daily screen exposure were associated with greater symptom severity and lower desmopressin response rates in children with primary monosymptomatic nocturnal enuresis. Assessment of screen habits may be considered a component of behavioral urotherapy counseling.