Dr. Hodges' approach to treating toileting problems is grounded in published research, including several studies conducted by pediatric nephrologist Sean O’Regan, M.D.
It was Dr. O'Regan who demonstrated that virtually all cases of enuresis, encopresis, and recurrent UTIs in children are caused by chronic stool withholding and that daily enemas resolves these problems.
Based on results in his clinic and his own published research, Dr. Hodges has modified Dr. O'Regan's regimen — hence the "Modified" O'Regan Protocol.
Dr. Hodges' research focuses not only the treatment of bedwetting and accidents but also a related question: Why are so many American children constipated? One answer suggested by his research: because they are toilet trained too early — at an age where they are prone to becoming chronic holders.
Dr. Hodges discusses his study, published in Research and Reports in Urology, that found children toilet trained as toddlers had triple the risk of developing daytime wetting later on.
Selected studies by Dr. Hodges:
-– Hodges SJ, Colaco M. Global Pediatric Health, 2016, 3: 1–4
– Hodges SJ, Richards KA1, Gorbachinsky I, Krane LS. Res Rep Urol., 2014 Oct 3;6:127-30.
– Hodges SJ, Anthony EY. Urology, 2012.
– Gorbachinsky I, Sherertz R, Russell G, Krane LS, Hodges SJ., Ther Adv Urol. 2014
Selected studies by Dr. O'Regan:
– Yazbeck S, Schick E, O’Regan S., Eur Urol, 1987
– O’Regan S, Yazbeck S, Schick E., Clin Nephrol, 1985
– O'Regan S, Yazbeck S, Hamberger B, Schick E., Am J Dis Child, 1986
Constipation and the Urinary System
Pediatric Urology, 1997; part Five, Chapter 16, Third edition, edited by Barry O’Donnell and Stephen A Koff.
Sean O’Regan, Salem Yazbeck and Eric Schick, pp 197-199
"After 16 years of managing urinary tract dysfunction in children, I would hypothesize that the number [of cases caused by constipation] is closer to 90-100%. Using a prevalence of 50% can cause gross under treatment."
– Angelique Champeau, director, Children's Continence Clinic at UCSF Benioff Children’s Hospital,
in an editorial comment published in the Journal of Urology