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available at http://www.ncbi.nlm.nih.gov/pubmed/31254367 Editorial Comment: In this series of 129 children (67.4% males) with a median age of 9.2 years the authors assayed urine sodium concentrations using a spot urine test to divide patients into those with appropriate (55) and excessive salt intake (74). Therapeutic responses after 1 month of treatment were compared for 39 children with appropriate and 50 children with excessive salt intake. Those with excessive salt intake showed a significantly reduced treatment response to desmopressin compared to the appropriate salt intake group. This report reminds us that we need to be looking carefully at nutrition, diet and salt intake in patients with recalcitrant monosymptomatic nocturnal enuresis. This study should push us all toward assaying for excessive salt intake in our patients with nocturnal enuresis. Douglas A. Canning, MD Re: Extraordinary Daytime Only Urinary Frequency in Childhood: Prevalence, Diagnosis, and Management P. Marzuillo, M. Diplomatico, R. Marotta, L. Perrone, E. Miraglia Del Giudice, C. Polito, A. La Manna and S. Guarino Department of Woman, Child and General and Specialized Surgery, Universit a degli Studi della Campania “Luigi Vanvitelli,” Napoli, Italy J Pediatr Urol 2018; 14: 177.e1ee6. doi: 10.1016/j.jpurol.2017.12.005 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/29456117 Editorial Comment: In this study of 13,200 children seen in the clinic over a 4-year period about 12% with voiding disturbances had extraordinary daytime only urinary frequency. A smaller proportion of children presented with symptoms in the summer vs in the winter, spring or fall (p[0.02). All had a normal flow rate. Only 1% of children with extraordinary daytime only urinary frequency had a thickened bladder on ultrasound. All patients responded to an exercise of postponing voiding for 3 hours. These children could get to 80% expected bladder capacity over a 3-hour period without incontinence. Three months later 98% of cases were improved. Thus, daytime only frequency is a self-limited problem that can be effectively treated with postponed voiding. Douglas A. Canning, MD Re: Early Start of Clean Intermittent Catheterization versus Expectant Management in Children with Spina Bifida W. Elzeneini, R. Waly, D. Marshall and A. Bailie Department of Paediatric Urology, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland J Pediatr Surg 2019; 54: 322e325. doi: 10.1016/j.jpedsurg.2018.10.096 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/30558962 Editorial Comment: The authors compare 2 groups of children with spina bifida and neuropathic bladder. The early start group underwent early initiation of clean intermittent catheterization, while the expectant group was a historical cohort of infants who were carefully monitored and expectantly managed by clean intermittent catheterization. Imaging in both groups included ultrasounds at age 1 week, every 3 months for the first year, every 6 months until age 3 years and then yearly. Voiding cystourethrograms, videourodynamic studies and dimercaptosuccinic acid scans were done every 1 to 2 years until about age 5 years. Renal scars developed in 18% of the early start group vs 39% of the PEDIATRIC UROLOGY 1049 Copyright © 2020 American Urological Association Education and Research, Inc. Unauthorized reproduction of this article is prohibited.