Abstract
To the Editor:
P
Case Report
A 9-year-old female had primary nocturnal enuresis with no known dry nights since birth. There was no history of daytime enuresis, or any history of leakage of urine during the day. The history was negative for urinary frequency. History of fecal incontinence was negative after toilet training. The patient's enuresis was unresponsive to multiple trials of pharmacologic agents, with evidence supporting their use for enuresis: Imipramine (Glazener et al. 2003) up to 2 mg/kg for 6 weeks, desmopressin (Glazener and Evans 2002) in doses up to 40 μg as nasal spray as well as 0.4 mg orally plus a trial of atomoxetine (Sumner et al. 2006). All had failed to produce even a single dry night. The patient's father recounted that he had had nocturnal enuresis through adolescence. He stated that their Native American grandmother had brewed a tea using a quart plus one tablespoon of water plus the green part of the silk from a dozen ears of fresh corn, which was brought to a boil and then allowed to cool. It was then strained to remove the silk. The dosing was a cup full on the first night and then a tablespoon dose each night until all the tea was gone. The father had been cured of nocturnal enuresis. After the daughter's enuresis had failed to be cured with the prescription agents detailed previously, she and her mother elected to try the corn silk tea treatment described. The daughter also experienced full remission after completion of the same regimen. At 3 month follow-up after completing the corn silk tea treatment, the patient had not had a single wet night.
Discussion
Chinese traditional medicine is reported to use corn silk infusions for hypertension and dropsy (Suzuki et al. 2007), and Zea mays is reported to be used for urinary problems and diabetes in Trinidad and Tobago (Lans 2006). These accounts may reflect diuretic properties; corn silk aqueous extract has been shown to have diuretic properties in some but not all studies (see Hasanudin et al. 2012 for review). Recently, hydrochlorothiazide was found to be better than placebo for nocturnal enuresis (Alawwa et al. 2010). Furosemide has also been reported to improve enuresis (Nevéus et al. 2005). Therefore, diuretic properties of corn silk tea are not inconsistent with the possibility that corn silk tea improves nocturnal enuresis. The multiplicity of failed pharmacologic trials in the daughter argue against, but do not rule out, a placebo effect.
Footnotes
Disclosures
No competing financial interests exist.